| ID | 323 |
|---|---|
| Name | INEVITABLE ABORTION |
| Cause | Unknown genetic abnormalities. Alcohol or drug use, infections, chronic disease, environmental exposures, and structural uterine abnormalities are other important risk factors |
| Signs Symptoms | Abdominal-pelvic cramping and vaginal bleeding |
| Diagnosis | Differential diagnosis: 1. Threatend abortion. 2. Hydatidiform mole. 3. Ectopic pregnancy. |
| Investigations | Inevitable abortion occurs when vaginal bleeding or rupture of membranes occur before 20 weeks gestation in the presence of cervical dilatation. Incomplete abortion typically occurs after 10 weeks gestation when the fetus is expelled and the placenta is retained in the uterus |
| Management | Surgically with suction D&C. A septic abortion requires broad spectrum antibiotic therapy prior to a suction D&C, if possible without delaying the D& |
| Introduction | |
| History | |
| Etiology | see under causes |
| Clinical Features | Clinical features: 1. History of amenorrhoea. 2. Bleeding which is severe. 3. Severe colicky pain. 4. Piece-meal or entire expulsion of the product of conception. 5. On exam, of the patient- low B.P, rapid thready pulse, anemia, there may be signs of shock; internal os is opened. |
| Preventions | |
| Treatment | Treatment: 1. Bed rest till abortion is complete. It is better to send the pt. in the hospital. 2. For relieve of anxiety, tension & pain- pethidine l00mg i.m injection. 3. If profuse bleeding and shock then immediate resuscitation of the patient by treatment of shock with sedative, i.v fluid, blood transfusion and 02 inhalation. 4. After the shock has been overcome uterus should be emptied by evacuation under deep sedation or G/A by sponge holding forcep or suction curette when size of uterus below 12 weeks. If uterus size above 12 weeks evacuation should be done on i.v 5 unit Oxytocin in 500ml of 5% D/A, 30-60 drops/minute. 5. Broad spectrum antibiotic, T.T, TIG to be given for prophylaxis. |
| Complications | Bleeding and lower abdominal cramping, accompanied by some degree of cervical dilatation. Bleeding may range from minimal to severe and even life threatening |
| Prognosis | |
| Types | It is the condition when the product of conception is bound to expell and nothing can be done to stop the process |
| Classification | |
| Observation | |
| Pathology |
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