This document discusses different types of abortion, including induced, spontaneous, threatened, inevitable, complete, incomplete, and missed abortions. It provides details on signs and symptoms, history, physical exam, and management for each type. Spontaneous abortions can occur in 20-25% of pregnancies due to embryo abnormalities, infection, or other issues. Threatened abortions involve bleeding with a closed cervix, while inevitable abortions have more severe symptoms and irreversible changes. Complete abortions expel all pregnancy tissues, while incomplete abortions retain some. Missed abortions occur after 20 weeks when the fetus dies but is retained.

1. ABORTION

2. Abortion

Induced



Therapeutic
Criminal
Elective

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. Abortion

Spontaneous




Threatened
Inevitable
Complete
Incomplete

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. Abortion

Inevitable





Vaginal bleeding
Moderately severe contractions
Possible amniotic sac rupture
Cervix effacement and dilation
Changes are irreversible

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. Abortion

Incomplete


Products of conception retained
Signs, symptoms





Profuse bleeding
Passage of tissue/clots
Severe contractions
Hypotension, shock
Sepsis

9. Abortion

Missed


Fetus dies in utero before 20th week
Retained at least 2 months afterwards

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. Abortion

History



Confirmed or suspected pregnancy
Abdominal pain, cramping
Bleeding, passage of tissue

12. Abortion

Physical Exam


Orthostatic vital signs (tilt test)
Examine for amount of vaginal bleeding,
presence of tissue

13. Abortion

Management






High concentration oxygen
IV or IV’s with LR
MAST if indicated
Do NOT pack vagina
Save any tissue passed
Transport