2. Definition:
Abortion means spontaneous or induced expulsion of products of conception
before viability (28 weeks) whereas premature labor is delivery of fetus after
28 weeks of pregnancy up to 40th week.
In medical practice, the abortion occurs in1st trimester, miscarriage in the
2nd trimester premature labor in the 3rd trimester.
Legally all the above terms are synonymous.
4. Type Definition
Early Abortion before 12 wk gestation
Late Abortion between 12 and 20 wk gestation
Spontaneous Noninduced abortion
Induced Termination of pregnancy for medical or elective reasons
Therapeutic Termination of pregnancy because the woman’s life or health is endangered
or because the fetus is dead or has malformations incompatible with life
Threatened Vaginal bleeding occurring before 20 wk gestation without cervical dilation
and indicating that spontaneous abortion may occur
Inevitable Vaginal bleeding or rupture of the membranes accompanied by dilation of
the cervix
Incomplete Expulsion of some products of conception
Complete Expulsion of all products of conception
Recurrent or habitual ≥ 2 to 3 consecutive spontaneous abortions
Missed Undetected death of an embryo or a fetus that is not expelled and that
causes no bleeding (also called blighted ovum, anembryonic pregnancy, or
intrauterine embryonic demise)
Septic Serious infection of the uterine contents during or shortly before or after
an abortion
http://www.msdmanuals.com/professional/gynecology-and-obstetrics/abnormalities-of-pregnancy/spontaneous-abortion#v1074677
6. Criminal Abortion
Criminal abortion is the induced destruction or expulsion of the foetus from the womb of the
mother unlawfully that is where there is no therauptic indication for operation.
Criminal abortion is usually undertaken by the
1. Widows for remarriage.
2. Unmarried girls.
3. Married woman of educated middle class to avoid addition to the family. Nowadays it is less due to
widespread knowledge of contraceptives.
4. The abortion may be undertaken solely for the purpose of sex determination to avoid female child.
7. Methods to induce Criminal Abortion
1. Mechanical violence ( general and local).
2. Abortifacient drugs.
3. Instruments.
8. Mechanical violence
General Mechanical Violence
These methods may act directly on the uterus or act indirectly by promoting congestion
of pelvic organs and causing haemorrhage between uterus and pelvic membranes. These
methods are:
1. Severe pressure over the abdomen as caused by the (blows, kicks, tight lacing and jumping)
2. Violent exercise such as (riding, cycling, jumping from height, jolting and lifting heavy weights.
3. Cupping: Cupping is placing a lighted wick over the hypogastric area and turning a brass mug over
the wick. The traction is applied over the mug that results in separation of placenta. The method is
usually employed in advanced months of pregnancy.
4. Very hot and cold baths alternatively.
5. Massaging the uterus through abdominal wall.
Local Mechanical Violence
While correcting the retroverted uterus bimanually
9. Abortifacient Drugs
The abortifacient drugs are:
1) Ecbolics:
They act directly on the uterus and increase the uterine contraction that causes abortion.
2) Emmenogogues:
They produce an increase menstrual blood flow and act as abortifacient when given in large doses.
3) Irritants of genitourinary tract:
these agents produce inflammation of genitourinary tract and irritates the uterus and induce uterine
contractions
4) Irritants of the Gastrointestinal tract:
They will excite uterus to contract “in sympathy” with the violent contractions of stomach and colon.
5) Drugs having poisonous effect on the body:
i. Inorganic irritants such as copper, mercury.
ii. Organic irritants such as unripe fruits of Papaya and Pineapple.
iii. Abortion Pill F-6103. It concentrates in the corpus luteum and acts by stimulating a woman's natural inclination to
menstruate even after presence of fertilized ovum and causes incomplete abortion.
10. Instruments
The instruments are used for the purpose of:
1. Rupture of membranes by introduction of penetrating instrument such as uterine sound,
catheter, pencil, knitting needle, hairpin, stick and even fingers.
2. Abortion stick: Abortion stick is a thin wood or bamboo stick, 12 to 18 cm (5-8 in) long and
its one end is wrapped with cotton wool or a piece of rag whose greater part is soaked with
juice of Marking nut, or a paste made of Arsenic oxide, sulphide etc.
Instead of stick, a twig of irritant plant such as calotropis.
3.Air insufflation: The air is instilled into vagina by means of syringes or pumps.
11. 4. Electricity: Negative pole is applied over the cervix and positive pole over sacrum
or lumber vessels and then the current is passed that results in uterine contractions
and subsequent abortion.
5. Paste: The paste containing iodine, thymol or mercury into the uterus
6. Syringing: Enema syringe with a hard bulb is commonly used to inject fluid in to
the uterus. A mixture of air and fluid is forced into uterine cavity at a higher
pressure than uterine veins. The fluid detaches parts of amniotic sac and placenta
from the uterine walls. The uterus contracts causing haemorrhage and thus abortion.
14. Immediate:
Hemorrhage
Perforation of uterus
Air embolism
Amniotic fluid embolism
Incomplete abortion
Local injury
Shock due to vagal inhibition resulting from instrumentation
