Abortion

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Abortion

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Abortion

  1. 1. ABORTION
  2. 2. Abortion  Induced    Therapeutic Criminal Elective
  3. 3. Abortion  Spontaneous    20 -25% of pregnancies terminate spontaneously Usually due to embryo abnormalities May also result from infection, unfavorable intrauterine environment, cervical incompetence
  4. 4. Abortion  Spontaneous     Threatened Inevitable Complete Incomplete
  5. 5. Abortion  Threatened  Vaginal bleeding, mild or absent contractions, closed cervix    20% of women bleed in early pregnancy 50% go on to abort Any bleeding in early pregnancy is dangerous and abnormal
  6. 6. Abortion  Inevitable      Vaginal bleeding Moderately severe contractions Possible amniotic sac rupture Cervix effacement and dilation Changes are irreversible
  7. 7. Abortion  Completed  Products of conception expelled     fetus placenta decidual lining Signs, symptoms     Profuse vaginal bleeding Passage of tissue, clots Continuing mild contractions Possible hypotension
  8. 8. Abortion  Incomplete   Products of conception retained Signs, symptoms      Profuse bleeding Passage of tissue/clots Severe contractions Hypotension, shock Sepsis
  9. 9. Abortion  Missed   Fetus dies in utero before 20th week Retained at least 2 months afterwards
  10. 10. Abortion  Missed  Signs/Symptoms    Continued amenorrhea History of bleeding without cramping Decrease in uterine size  Resorption of fluid  Calcification of products of conception
  11. 11. Abortion  History    Confirmed or suspected pregnancy Abdominal pain, cramping Bleeding, passage of tissue
  12. 12. Abortion  Physical Exam   Orthostatic vital signs (tilt test) Examine for amount of vaginal bleeding, presence of tissue
  13. 13. Abortion  Management       High concentration oxygen IV or IV’s with LR MAST if indicated Do NOT pack vagina Save any tissue passed Transport

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