Abortion (miscarriage)

Abortion :-

Synonymous -miscarriage

Definition -it is expulsion or extraction of products of conception before fatal viability :i. e before 24 weeks of gestation.

Termination of pregnancy before viability.

Expulsion of fetus or an embryo weighing 500gm or less.

Common causes -genetic factor, endocrine (thyroid, luteal phase disease, diabetes),immunological, infection, unexplained, uterine synechiae(ashermen syndrome), cervical incompletence, anatomical abnormalities, mullerian fusion defect.

Classification -1)spontaneous-below 7 types
(2) induced abortion.

Methotrexate and misoprostol -up to 7 weeks.
Medical abortion up to 10 weeks
Vacuum aspiration up to 16 weeks
Dilation and evacuation after 14 weeks
Induction Second trimester 13 to 27 weeks.

Pathology -

Haemorrhage in to decidua basalis › necrotic changes in tissue ›› adjacent to the bleeding ›››detachment of conceptus ›››› the above will stimulate uterine contraction »»» resulting in expulsion .

Abortion types :-

1)Complete abortion -when products of conception are expelled it is called...

2)Incomplete abortion -when the entire product of conception are not expelled, Instead it is left in side the uterine cavity it is called....

3)Inevitable abortion -product of conception are still intact in the uterus.

Symptoms of pregnancy loss, bleeding, cervical dilation, cramping, abdominal pain.

4)Missed abortion -when the embryo or fetus is already died but still remain in uterine cavity for a period of time without symptoms of miscarriage.

No bleed, no dilation.

5)Threatened abortion -vaginal bleeding before 24 weeks there a viable fetus without evidence of cervical dilation and pain.

6)Septic abortion -infection may occur following any types of abortion and may spread to pelvic or even leads to septicemia.

7)Reccurent abortion -Three or more consecutive miscarriage.

Milan Tomic

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