Complete - Complete abortion is the termination of a pregnancy before the age of viability almost in 50% cases. It occurs at less than 20 weeks from the first day of the last normal menstrual period or involving a fetus of weight less than 500gm.
Incomplete – It is the spontaneous passage of some of the products of conception associated with uniform pregnancy loss.
Inevitable – It is the pregnancy in which rupture of the membranes and/or cervical dilation takes place during the first half of the pregnancy period.
Missed - It is the retention of a failed intrauterine pregnancy, which can be detected by an ultrasound.
Septic – It is a variant of an incomplete abortion due to infection.
Threatened – It is a pregnancy in which vaginal bleeding or uterine cramping occurs. 50-60% such pregnancies come in the category of complete abortion.
Endocrine abnormalities in about 25-50% cases.
Genetic factors in about 10-70% cases.
Trisomy in about 40-50% cases.
Monosomy in about 15-25% cases.
Reproductive tract abnormalities in about 6-12% cases.
Tripoidy and tetraploidy in about 5-15% cases.
Abnormality of placentation.
Effect of venereal diseases.
Chronic cardiovascular disease and chronic renal disease.
Environmental factors such as alcohol, anesthetic gases, effect of drugs, radiation, smoking and toxins.
Other factors such as advanced maternal age, delayed fertilization, short interval between pregnancies.
Vaginal bleeding which would be bright red to dark coloured.
Abdominal cramping generally rhythmic accompanied by pelvic or low back pressure.
Cervical dilation with tissue visible at the cervical openings.
Severe vaginal hemorrhage.
Cervical polyps and cervicitis.
Urinary tract infection and lower abdominal discomfort.
Loss of early symptoms such as fullness of breasts or morning sickness.
Disseminated intra-vascular coagulopathy can occur when an intrauterine fetal demise in the second trimester has been retained beyond six weeks after the death of the fetus.
Rh-negative mothers should be treated with Rh immune globulin after completion of the abortion, because ovulation may occur as early as two weeks after an abortion.
After an abortion, control the bleeding, prevent infection and relieve pain.
Ensure that all the products of the conception have been expelled from the uterus. If retained tissues are present and cannot be ruled out, curettage must be performed immediately.
Septic abortion requires urgent and aggressive management. Antibiotics, fluid therapy and prompt evacuation of the uterus are indicated.
If significant pain or bleeding persists, especially bleeding leading to hemodynamic alterations, evacuation of the uterus should be conducted.
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