| ID | 322 |
|---|---|
| Name | THREATENED ABORTION |
| Cause | Chromosomal problems with the fetus. Previously having a miscarriage. Alcohol or drug use or exposure to chemicals early in the pregnancy. Having obesity. Being older than 40 during pregnancy. Smoking cigarettes or vaping. Problems with the placenta. Trauma or injury. |
| Signs Symptoms | Bleeding may be mild or severe. Pain and cramping may be present in the lower abdomen, lower back, buttocks, and genitals. Other symptoms associated with a true miscarriage include the passage of blood clots and tissue fragments. |
| Diagnosis | Differential diagnosis: Ectopic pregnancy, missed abortion, metropathia hemorrhagica. |
| Investigations | Investigation: 1. Blood for Hb%, TC, DC, ESR, ABO & Rh blood grouping. 2. Urine for R/E and estimation of pregnanendiol. 3. Vaginal cytology. 4. Ultrasonography of the uterus for diagnose the condition of the product of conception. |
| Management | Prescribe progesterone, a hormone that supports a pregnancy. Low levels of progesterone may be a sign of a threatened miscarriage. Can prescribe progesterone through injections, suppositories or tablets |
| Introduction | In this case there is threat of abortion but it may or may not progress to abortion. After treatment pregnancy can be continued. |
| History | |
| Etiology | see under causes |
| Clinical Features | Clinical features: 1. History of amenorrhoea. 2. Slight bleeding per vagina which stops if preg-nancy continues. Bleeding may recur. 3. Pain slight or absent. 4. On exam- internal os is closed in multipara; exter-nal os is closed in primi. |
| Preventions | |
| Treatment | Treatment: 1. Absolute bed rest for 5-7 days after all bleeding has ceased. 2. Sedative- pethidine 100mg initially follwed by diazepam 5mg t.d.s. 3. Hormone therapy for uterine rest- a. 17a-hydroxyprogesterone caproate 125-250mg i.m weekly for 6-8 weeks. Or, b. Dydogesterone (gestanine) 5mg t.d.s for 4-6 months. Or, c. Progesterone 25-60mg daily by mouth till bleeding ceased. 4. Treatment of cause. 5. Antibiotics if infection. 6. Avoid coitus and travelling. |
| Complications | Pregnancy loss (progression to inevitable, incomplete, complete, missed abortion) Heavy bleeding. Retained products of conception. Endometritis. Septic abortion. Complications later in pregnancy as discussed in "Prognosis" [20] |
| Prognosis | |
| Types | |
| Classification | |
| Observation | |
| Pathology |
© Pakistan Drug Directory. All Rights Reserved.
Designed By: Pakistan Drug Directory Team