Abortion

What is abortion?

An abortion is the premature exit of the products

of conception (the fetus, fetal membranes, and
placenta) from the uterus. It is the loss of a pregnancy
and does not refer to why that pregnancy was lost.
 Types of Abortion

 Spontaneous Abortion
 Induced Abortion
Types of spontaneous abortion:
 Threatened abortion
 Inevitable abortion
 Complete abortion
 Incomplete abortion
 Missed abortion
 Types of induced abortion:

 Menstrual Extraction (endometrial or

vacuum aspiration)
 Dilation and Evacuation (D & E) (also
called vacuum suction or suction
curettage) and Dilation and Curettage
(D & C). 
 Prostaglandin or Saline Administration
 Hysterotomy
 Etiology
The most frequent cause of miscarriage is
abnormal fetal formation, due to either to
a teratogenic factor or a chromosomal
abberation.
Poor maternal nutritional status
In others, immunologic factors may be
.present or rejection of the embryo
through an immune response.
It also involves the implantation
abnormalities.
It also occurs if the corpus luteum fails
to produce enough progesterone to
maintain the decidua basalis.
Infection such as rubella, syphilis,
poliomyelitis, cytomegalovirus and
toxoplasmiosis can also cause abortion.
Ingestion of teratogenic drugs can
cause abortion.
 Clinical Manifestations
•Uterine cramping, low back pain.
•Vaginal bleeding usually begins as dark
spotting, then progresses to frank bleeding as
the embryo separates from the uterus.
•ß-hCG level may be elevated for as long as 2
weeks after loss of the embryo.
Ultrasonic evaluation of the gestational
sac or embryo
Visualization of the cervix; presence of
dilatation or tissue evaluated

Diagnostic Evaluation
Complications
Uterineinfection
Septicemia
Hemorrhage
Disseminated Intravascular
Coagulation(DIC) in missed abortion.
Schematic Diagram of Infection
Abortion Immunologic
Factors Crosses
placenta
Teratogenic
Factors
Rejection of the Fetus fails
(smoking,
embryo through to grow
alcohol, drugs)
immunologic
response
Decrease estrogen
and progesterone
Abnormal Fetal production
Formation
Endometrial
sloughing
Miscarriage

Release of
prostaglandin which
causes uterine
contractions and
cervical dilatation
Nursing Diagnoses
Nursing Diagnosis
•Risk for fluid volume deficit r/t maternal
bleeding

Nursing Interventions
•Report any tachycardia, hypotension,
diaphoresis, or pallor, indicating hemorrhage
and shock.
•Draw blood for type and screen for possible
blood administration.
•Establish and maintain an IV with large-bore
catheter for possible transfusion and large
quantities of fluid replacement.
Nursing Diagnosis
•Anticipatory grieving r/t loss of pregnancy, cause of
abortion, future childbearing

Nursing Interventions
•Assess the reaction of patient and support person, and
provide information regarding current status, as
needed.
•Encourage the patient to discuss feelings about the
loss of the baby’ include effects on relationship with
the father.
•Do not minimize the loss by focusing on future
childbearing; rather acknowledge the loss and allow
grieving.
•Providing time alone for the couple to discuss their
feelings.
Nursing Diagnosis
•Risk for infection r/t dilated cervix and open uterine
vessels

Nursing Interventions
•Evaluate temperature q 4H if normal, and every 2H if
elevated.
•Check vaginal drainage for increased amount and
odor, which may indicate infection.
•Instruct on and encourage perineal care after each
urination and defecation to prevent contamination.
Nursing Diagnosis
• Acute pain r/t uterine cramping and possible
procedures

Nursing Interventions
•Instruct patient on the cause of pain to decrease
anxiety.
•Instruct and encourage the use of relaxation
techniques to augment analgesics.
•Administer pain medication as needed and as
prescribed.
Nursing Diagnosis
•Knowledge deficit r/t signs and symptoms of possible
complications
Nursing Interventions
•Teach the woman to observe for signs of infection (fever,
pelvic pain, change in character and amount of vaginal
discharge), and advise to report them to provider
immediately.
•Deal with client’s anxiety. Present information out of
sequence, if necessary, dealing first with material that is
most anxiety producing when the anxiety is interfering with
the client’s learning process.
•Teach client of the complications for a mother has reason to
be especially worried about her infant’s health.