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1. PRESENTATION
Abdul Moeed G6
ABORTION
INTRODUCTION
EPIDEMIOLOGY
ETIOLOGY
CLASSIFICATION
DIAGNOSIS
MANAGEMET

2. INTRODUCTION
The termination or removal of the pregnancy
before the normal pregnancy. Expected time
for abortion is before <24 week from the first
day of last menstrual period.
There are mainly two processes Medical
(with help of Pills) & surgically which are
depend on the condition of patient.

3. EPIDEMIOLOGY
1. SMOKING: When a woman taking 5 unit of
cigarettes in first week of pregnancy OR 3
unit of cigarettes in in first trimester
2. CAFFEINE: When a woman taking 5 cup of
tea which have estimate above 50 gm of
caffeine
3. OBESITY: When a women body mass index
BMI is above 28 have 68-72 % chance of
abortion.

4. CLASSIFICATION
Mainly divided into Spontaneous &
Induced Abortion.
1. Spontaneous Abortion:Also
called miscarrage it is loss of pregnency
before 20 weeks of gestation.
Approximately 50-70% of all losses pregnancy
and 20% of those which are clinically
recognized pregnancies are spontaneous
abortion.

5. CLASSIFICATION
Types of Spontaneous Abortion Vaginal
Bleeding & Fetal Loss
Vaginal bleeding <20 weeks
Cervix Open?
No Yes
Threatened Abortion Inevitable Abortion

6. SPONTANOUS ABORTION
• Fetal loss < 20 weeks
Tissue Expulsion
None + Infection
Some All
Missed Septic
Incomplete
Complete

7. ETIOLOGY
1. FETAL
Chromosomal anomalies
Most common
Autosomal trisomy like T16 trisomy which
are most common abnormality & T22
trisomy also the most common abnormality.
Chromosome X (X45) monosomy also one of
them. •

8. ETIOLOGY
2. MATERNAL
(i) Anatomic
(a) Uterine anomalies
(b) Cervical Insufficiency
Abnormal opening in
cervix instead of normal
cervix.

9. (ii) Hematologic
Thrombophilia.
(iii) Endocrine
Poorly controlled diabetes & Progesterone
deficiency.
(iv) Infection
Like viral ie Rubella, Cytomegalo,
Hiv,Gonorrhoea, Syphilis
ETIOLOGY

10. DIAGNOSE of S ABORTION
(i) Pelvic Examination Check out the pelvic
as it begun to dilate or not.
(ii) Ultrasound In usg check the fetal
heartbeat and determine about the embryo
developing are not.
(iii) Blood Test Check the level of the HCG
hormone in the blood and compare it to the last
Blood test HCG level if the changes occur in the
level so it indicate the problem.

11. DIAGNOSE of S ABORTION
(iv) Tissue Test Some time tissue passed
during abortion that tissue sent to labe for
further examination about abortion.
(v) Chromosomal Test When recurrent
abortion occur then must want to test the
chromosome of both maternal & paternal.

12. Incomplete & Spontaneous Abortion

13. HCG level normal chart and after abortion

14. MNAGMENT of S ABORTION
(i) Medical Medication for uterine explosion
Misoprostol+Mifepristone orally ist 200 mg
Mifepristone after 24 or 48 hour latter 800mgc (4
tablet of 200mgc) Misoprostol put b/t checks &
gums for 30 minutes.
Also both of these can use vaginaly.
(ii) Surgical Dilation & Curettage (D&C) it is a
surgical procedure of Cervix dilate & scraped the
uterine lining & spoon like instrument insert
through which abnormal tissue removed.

15. CLASSIFICATION
2. INDUCED ABORTION
It is surgical or medical termination of pregnancy
most of the induced abortion done in the 12
weeks of gestation age.

16. ETIOLOGY •
(i) Maternal Health Care An any abnormality
related to mother.
(ii) Rape An incidence occour mostly with poor
people.
(ii) Fetal Anomalies Mean chromosomal ….
(iv) Maternal Economic Those people who
economical issue.
(iv) Unplanned Pregnancy Currently world
wide most common cause.

17. TYPES & TREATMENT OF I ABORTION
First Trimester
Medcation Abortion
Mifepristone+Misoprosto
l upto 63 day of
gestation.
Methotrexate+Misoprost
ol upto 49 days of
gestation.
Uterine Suction
Aspiration/Dilation &
Curettage (D&C).
Second Trimester
Dilation & Evacuation
Wide cervical dilation and
removal of uterine
contents.
Labour Induction
Mifepristone+Misoprosto
l
Oxytocin
Foley Bulb.

18. COMPLICATIONS & RATE
Hemorrhage
Infection
Uterine Perforation
Cervical Laceration
Acute hematometra
Asherman's Syndrome
Death
0.05-4.9/100
1/100
0.2/100
0.01-1.6/100
0.1-1/100
Very Rare
0.6/100,000

19. Thank You