ABORTlON

l. Types:
A. Spontaneous aborton s the expuson of the fetus
and other products of concepton from the uterus
before the fetus s capabe of vng outsde of the
uterus.
1.Threatened abortion - s characterzed by
crampng and vagna beedng n eary pregnancy
wth no cervca daton. It may subsde or an
ncompete aborton may foow.
2. lmminent or inevitable abortion s
characterzed by beedng, crampng and cervca
daton. Termnaton cannot be prevented.
3. lncomplete abortion s characterzed by
expuson of ony part of the products of concepton
(usuay the fetus). Beedng occurs wth cervca
daton.
4. Complete abortion s characterzed by compete
expuson of a products of concepton.
5. Missed abortion s characterzed by eary feta
ntrauterne death wthout expuson of the products
of concepton. The cervx s cosed, and the cent
may report dark brown vagna
dscharge. Pregnancy test fndngs are negatve.
6. Recurrent (habitual) abortion s spontaneous
aborton of three or more consecutve pregnances.

B. Induced aborton a vountary nduced termnaton
of pregnancy
1. Vacuum Aspraton- the cervx s dated manuay
wth nstrumentaton or by amnara (sma
suppostores madeof seaweed that swes as t
absorbs water).
2. Dataton and evacuaton- cervca dataton wth
amnara ff by vacuum aspraton.
3. Labor nducton
4. Medca Aborton
a. Mfeprstone- used ony n eary pregnancy(49 days)
b. Methotrexate
c. Msoprosto
lll. Etiology
1. Feta Factors
a. Defectve embryoogc deveopment
b. Fauty ovum mpantaton
c. Re|ecton of the ovum by the endometrum
d. Chromosoma abnormates
2. Pacenta Factors
a. Premature separaton of the normay
mpanted pacenta
b. Abnorma pacenta mpantaton
c. Abnorma pacenta functon
3. Materna Factors
a. Infecton
b. Severe manutrton
c. Reproductve system abnormates (eg, ncompetent
cervx)
d. Endocrne probems (eg, thyrod dysfuncton)
e. Trauma
f. Drug ngeston
lV. Pathophysiology The feta or pacenta defect or the
materna condton resuts n the dsrupton of bood fow,
contanng oxygen and nutrents, to the deveopng fetus. The
fetus s compromsed and subsequenty expeed from the
uterus.

V. Assessment Findings
1. Assocated fndngs The cent and famy may exhbt a
gref reacton at the oss of pregnancy, ncudng:
a. Cryng
b. Depresson
c. Sustaned or proonged soca soaton
d. Wthdrawa
2. Clinical Manifestations ncude common sgns and
symptoms of spontaneous aborton.
a. Vagna beedng n the frst 20 weeks of pregnancy
b. Compants of crampng n the ower abdomen
c. Fever, maase or other symptoms of nfecton
3. Laboratory and dagnostc study fndngs
a. Serum beta hCG eves are quanttatvey ow
b. Utrasound reveas the absence of a vabe fetus.
Vl. Medical mgt
A. 6pontaneous
A tssue passed vagnay s saved for
examnaton.
(for rare case of heavy beedng ) may requre
bood component transfuson and fud
repacement. (can be det. By recordng the
number of pernea pads)
Incompete- oxytocn may be prescrbed.
B. lnduced
a nurse traned n pregnancy counseng expores
wth the patent fears, feengs and optons.
Pevc exam (to determne uterne sze)
Lab test before an aborton (preg test) to confrm
the pregnancy, hematocrt (to rue out
anema), Rh determnaton and STD screen.
Vll. Nursing mgt
A. 6pontaneous
Pt exp oss and anxety- emotona support and
understandng.
Grevng perod
Provde opportuntes for the patent to tak and
express her emotons.
B. lnduced
Woman undergong eectve aborton s nformed
about what the procedure entas and
expected course after the procedure.
Foow-up appontment after 2 weeks.
Avaabe contraceptves are revewed. (f
not usng contracepton expan a
methods, ther benefts and rsks, assst the
pt n makng a contraceptve choce)
Psychoogca support