This document provides an overview of abortion presented by Sunny Alva Kharshandi. It defines abortion and outlines the main etiological factors, including ovo-fetal, maternal, trauma-related, toxic, and immunological causes. Various types of abortions are discussed such as threatened, inevitable, incomplete, missed, and septic abortions. Treatment options including medical and surgical management are presented. Complications of both legal and illegal abortions are covered. The document concludes with nursing responsibilities in abortion care and amendments to abortion laws.

1. PRESENTATION
ON
ABORTION
BY SUNNY ALVA KHARSHANDI

2. DEFINITION
Abortion is the termination of pregnancy before the
period of viability which is considered to occur at 20th
week.

3. ETIOLOGY
 OVO-FETAL FACTORS (60%)
(a)the ovo-fetal factors usually operate in early fetal
wastage.
(b)Interference with the circulation in the umbilical cord
(c)Low attachment of the placenta
(d)Twins or hydramnios

4. CONT.
MATERNAL FACTORS (15%)
A).Maternal illness
-Infection
-Maternal hypoxia and shock
-Chronic illness
-Endocrine factors

5. CONT
B)TRAUMA
-Direct trauma on the abdominal wall
-Psychic
-minor trauma
-Amniocentesis, chorion villus sampling or abdominal
surgery in early months may cause abortion.

6. CONT.
c) Toxic agents
-environmental toxins like lead, arsenic, anaesthetic
gases, tobacco, caffiene, alcohol, radiation in excess
amount increase the risk of abortion.

7. CONT.
(d) Cervico-uterine factors
-Cervical incompetence
-Congenital malformation of the uterus
-Uterine tumour
-Retroverted uterus

8. CONT.
(e)Immunological
(f) Blood group incompatibility
(g)Premature rupture of membranes
h)Dietetic factors

9. PATERNALFACTORS
Unknown (25%)

10. MECHANISM OFABORTION
-Before 8weeks
-8-14weeks
-Beyond 14th week

11. SPONTANEOUS ABORTION
Spontaneous abortion is defined as non-induced embryonic
or foetal death or passage of products of conception before 20
weeks.

12. SYMPTOMS:

13. CAUSES

14. PREVENTION

15. COMPLICATIONS

16. ISOLATED ABORTION

17. RECURRENTABORTION
Recurrent abortion is the loss of three or more sequential
pregnancies before 20 weeks' gestation.

18. CAUSES
• Genetic factors
• Immunological factors
• Chromosomal abnormalities
• Hormone imbalance
• Life style

19. DIAGNOSIS
 Ultrasound scan
 Blood test for antiphospholipid antibodies

20. TREATMENT
• No treatment may be appropriate for many couples
• A supplement of the hormone progesterone
• Psychological support

21. THREATENEDABORTION
A threatened abortion is vaginal bleeding that occurs in
the first 20 weeks of pregnancy.

22. CAUSES

23. SYMPTOMS OFTHREATENEDABORTION

24. DIAGNOSIS
• ultrasound
• blood test

25. TREATMENT
• Bedrest
• administer rh immunoglobulins
• prescribe progesterone
• prescribe haemostatic drugs.
• Sedation and relief of pain may be ensured by phenobarbitone
30mg or diazepam 5 mg tablet twice daily.
• Mild laxatives 4 teaspoons at bedtime may be prescribed if
required. Enema should not be given.

26. PREVENTION

27. ADVICE ON DISCHARGE

28. INEVITABLEABORTION
It is the clinical type of abortion where the changes have
progressed to a state front where continuation of
pregnancy is impossible.

29. SYMPTOMS

30. SIGNS
 Maternal vital signs
 Uterine size
 Pelvic exam

31. COMPLICATIONS
 Blood loss
 Infection

32. MANAGEMENT

33. COMPLETEABORTION
When the products of conception are expelled in
mass, it is called complete abortion

34. SYMPTOMS

35. CLINICALFEATURES
Vaginal bleeding
Internal examination

36. MANAGEMENT

37. INCOMPLETEABORTION
when the entire products of conception are not
expelled, instead a part of it is left inside the
uterine cavity, it is called incomplete abortion

38. CLINICALFEATURES
(1)Continuation of pain in lower abdomen,
(2) Persistence of vaginal bleeding
(3) Internal examination reveals- (a) uterus smaller than the period of
amenorrhoea.
(b) patulous cervical os often admitting the tip of the finger and
(c) varying amount of bleeding.
(4) on examination the expelled mass is found incomplete.

39. MANAGEMENT:
In recent cases – the same principles are followed as that
of inevitable abortion.
Early abortion: dilatation and evacuation under general
anaesthesia is to be done.
Late abortion: the uterus is explored under general
anaesthesia by finger and the products left behind is either
removed by ovum forceps or by blunt curette.

40. MISSEDABORTION:
A missed abortion is a miscarriage in which your
foetus didn’t form or has died, but the placenta and
embryonic tissues are still in your uterus. It’s
known more commonly as a missed miscarriage.
It’s also sometimes called a silent miscarriage.

41. PATHOLOGY

42. SYMPTOMS:

43. SEPTICABORTION
A septic abortion "is an infection of
the placenta and foetus (products of conception) of
a previable pregnancy. Infection is centered in the
placenta and there is risk of spreading to the uterus,
causing pelvic infection or becoming systemic to
cause sepsis and potential damage of distant vital organs”.

44. SIGNSAND SYMPTOMS

45. CAUSES
• multiple strains of gram positive and/or gram negative
bacteria.
• sexually transmitted infections (STI) such as chlamydia

46. RISK FACTORS:

47. TREATMENT:
intravenous fluids
Broad-spectrum intravenous antibiotics
A dilatation and curettage (D&C) or misoprostol

48. LEGALABORTIONS
Five possible degrees of restrictiveness of abortion laws can exist for
a given country.
1. Abortion is permitted without restriction as to reason
2. Abortion is permitted on socio-economic grounds (woman’s
economic resources, her age, her marital status, and number of her
living children.
3. It is permitted to protect a woman’s mental health, as well as her life
and physical health.
Abortion is permitted only to save a women’s life, or the procedure is
banned entirely

49. ILLEGALABORTION
An unsafe abortion is the termination of a pregnancy by
people lacking the necessary skills, or in an environment
lacking minimal medical standards, or both. An unsafe
abortion is a life threatening procedure.

50. METHODS OF UNSAFEABORTION

51. COMPLICATIONSAND THEIR TREATMENTS INCLUDE
• Infection: antibiotics prescribed
• Haemorrhage

52. ABORTIONAS HUMAN RIGHTS

53. PROFESSIONALRESPONSIBILITYOFANURSE IN
ABORTION:

54. ABORTION PROCEDURES
Methotrexate & Misoprostol (MTX)
Mifepristone and Misoprostol
Manual Vacuum Aspiration (MVA)
Aspiration
Dilation & Curettage (D & C
Induction Abortion

55. THIRD TRIMESTER
• Induction Abortion
• Dilation and Extraction

56. COMPLICATIONS OFABORTIONS:
 Possible complications of surgical abortion include:
• Retained Tissue
• Failure to Terminate the Pregnancy
• Blood Clots in the Uterus
• Infection
• Haemorrhage
• Cervical Tear
• Perforation
• Anaesthesia Reactions
• Cardiac Arrest
• Death

57. POSSIBLE COMPLICATIONS OF
NON-SURGICALABORTION
INCLUDE
Retained Tissue
Failure to Terminate the Pregnancy
Blood Clots in the Uterus
Infection
Haemorrhage
Death

58. MEDICAL MANAGEMENT

59. SURGICALMANAGEMENT

60. NURSING MANAGEMENT
Nursing Assessment
Nursing Interventions
Nursing Evaluation

61. THE BILLAMENDS THE MEDICAL
TERMINATION OFPREGNANCYACT, 2020.

62. CONCLUSION