Hi fellow steemians.Today I am presenting a short article about abortion.

Abortion

figure:abortion

Abortion is the expulsion of fetus before the period of viability i.e 22 weeks of gestation or if the weight of the fetus is below 500 gram .In developing countries it is 28 weeks and in developed countries it is 22 weeks of gestation.In simple words if the fetus or baby is expelled out the womb before it can survive on its own then, the term miscarriage or abortion is given

Clinically,Abortion is of 2 types
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classificaton

Spontaneous abortion:

It is the involuntary loss of the fetus before the period of viability.Incidence is 80% in the first trimester.The causes for spontaneous abortion can be

• due to abnormal fetal formation
• due to Urinary tract infection (UTI)
• lack of progesterone leading to shredding of decidua basalis
• teratogenic drugs
• defect in the immunological system
• Inappropiate site for transplantation
  

Threatened Abortion

It is a clinical entity where the process of abortion has started but has not progressed to a state from wich recovery is possible

Clinical features of threatened abortion are:
a) bleeding from vagina is slight and bright red in color
b) there is mild backache and dull pain over lower abdomen

On pelvic examination we can find the bleeding from the external os

Investigation that can be done are

• Blood test,USG,urine test for immunological test of pregnancy

Treatment
Analgesics and sedation drugs can be given

• Phenobarbitione 30mg or Diazepam 5mg with at least proper bed rest for 2 weeks.

Advises

• No heavy work
• No coitus during that period
• Regular follow-up

Inevitable Abortion

It is a clinical entity where the process of abortion where the changes have progressed to a state where the continuation of pregnancy is impossible.

Clinical features of Inevitable abortion are:
a) increased per vaginal bleeding
b)severe colicky pain over the lower abdomen

on per vaginal examination the fetus implantation can be felt

Managment of this abortion should be done properly with the aim of

• prevention of sepsis
• accelerate the process of expulsion

Treatment can be done on the basis of period of gestation

1. before 12 weeks: cervix is dilated and evacuation followed by the curettage of the uterine cavity
2. after 12 weeks: with the help of oxytocin drip(pregnancy inducing drug) 10 units in 500ml in Normal saline is given for
   1 hour.

If there is too much bleeding,it should be controlled by administering methergine and also blood transfusion should be done

Thank you fellow steemians for reading my post.
Next part will be posted soon so please stay tuned.

Reference

1. https://www.slideshare.net/sindhujojo/abortionppt-for-2nd-msc
2. http://i.dailymail.co.uk/i/pix/2007/10_02/foetusDM1210
3. DC Dutta's textbook of obstetrics

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