| ID | 321 |
|---|---|
| Name | ABORTION |
| Cause | Causes: 1. Malformation of the zyogte e.g chromosomal abnormality, vesicular mole etc. 2. General diseases of the mother e.g- i. Maternal infection with rubella and syphilis, ii. Diabetes. iii. Hypertension & renal disease. iv. Acute emotional disturbances etc. 3. Uterine abnormalities e.g septate or double uterus, uterine retroversion, fibromyoma, incompetence of internal os of cervix etc. 4. Hormonal imbalance- e.g both thyroid deficiency and hyperthyroidism. 5. Irradiation of the uterus during early pregnancy. 6. Drugs e.g cytotoxic drugs, oxytocin, quinine, ergot alkaloids, prostaglandins etc. 7. Trauma- severe trauma to the uterus. |
| Signs Symptoms | Bleeding from the vagina with or without pain, including light bleeding called spotting. Pain or cramping in the pelvic area or lower back. Fluid or tissue passing from the vagina. Fast heartbeat. |
| Diagnosis | Pelvic examination, measurement of beta subunit of human chorionic gonadotropin, and ultrasonography |
| Investigations | Pelvic examination, measurement of beta subunit of human chorionic gonadotropin, and ultrasonography |
| Management | Medical management of spontaneous and induced abortion (for both viable and non-viable pregnancies) at early or later gestational ages involves the use of a single-dose regimen or a combination regimen of medicines used in sequence, with specific dosages and routes of administration. Mifepristone in combination with misoprostol, or misoprostol alone. Similar to mifepristone, letrozole can be used in combination with misoprostol for medical abortion at early gestational ages. Letrozole is a third-generation selective aromatase inhibitor. Its mechanism of action involves suppression of estrogen levels, which modifies the progesterone receptor concentration, subsequently leading to pregnancy loss. |
| Introduction | Abortion is the expulsion or attempted expulsion of the poduct of conception before the 28th week of pregnancy. |
| History | |
| Etiology | see under cause |
| Clinical Features | see under symptoms |
| Preventions | Not smoking during pregnancy Not drinking alcohol or using illegal drugs during pregnancy Eating a healthy, balanced diet with at least 5 portions of fruit and vegetables a day Making attempts to avoid certain infections during pregnancy, such as rubella Avoiding certain foods during pregnancy, which could make ill or harm the baby Being a healthy weight before getting pregnant |
| Treatment | Medical management of spontaneous and induced abortion (for both viable and non-viable pregnancies) at early or later gestational ages involves the use of a single-dose regimen or a combination regimen of medicines used in sequence, with specific dosages and routes of administration. Mifepristone in combination with misoprostol, or misoprostol alone. Similar to mifepristone, letrozole can be used in combination with misoprostol for medical abortion at early gestational ages. Letrozole is a third-generation selective aromatase inhibitor. Its mechanism of action involves suppression of estrogen levels, which modifies the progesterone receptor concentration, subsequently leading to pregnancy loss. |
| Complications | Infection. Bacterial infection is an uncommon complication of abortion. ... Incomplete abortion. ... Cervical injury. ... Uterine perforation. ... Heavy bleeding (hemorrhage) ... Retained blood clots in the uterus. ... Allergic reactions and Anesthesia-related complications. ... Breast cancer. |
| Prognosis | |
| Types | Clinical types: 1. Threatened abortion. 2. Inevitable abortion- complete & incomplete 3. Missed abortion. 4. Septic abortion. 5. Habitual or Recurrent abortion. |
| Classification | |
| Observation | |
| Pathology |
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