• August 5, 2022
• By lewisanimbom@gmail.com
• Health

Pregnancy Complications

Abortion

Abortion is the interruption or termination of pregnancy before 28 weeks. The causes of abortion ranges from foetal causes, and maternal cause

What are the Foetal Causes

• abnormalities of chromosomes
• diseases of the fertilized ovum
• Hypoxia from the separation and damage of the placenta which impair normal development of the embryo.

What are the Maternal causes

• Infection such as severe malaria, chronic nephritis may cause the death of the foetus
• Effect of certain drugs used to induce abortion especially in large doses
• Endocrine dsyfunctioning such as progesterone deficiency
• ABO incompatibility between mother and embryo

Signs and symptoms of Abortion

Abortion may have the following signs and symptoms;

• Vagina bleeding due to partial detachment of the embedded embryo
• Pains due to uterine contraction in the lower abdomen.
• Dilatation of the cervical os

What are the Types of Abortion

Two main types of abortion exist, spontaneous and induced abortion

Spontaneous abortion

This is the interruption of pregnancy before the 26 weeks of gestation caused by natural factor. The foetus here is first expelled follow by the separation of the placenta. Bleeding is control by uterine contraction

Some spontaneous abortion may become threatening abortion and may likely go to term. Examples Of spontaneous abortion may include the following,

• Complete Abortion

This is an abortion where all the product of conception is expelled out; leaving the uterus empty and bleeding is control.

• Incomplete abortion

This is an abortion where only the foetus is expelled out, but the placenta, and the cord are held in the uterus, and bleeding is not control.

NB Habitual aborter refers to a lady who has had three or more abortion successfully’

Induced Abortion

It is an abortion carried out after investigations have proven that the pregnancy will cause harm either to the mother or the foetus itself.

This type of abortion are carried out for selfish reasons for which most equipment use are unsterilized and may end up causing more infection, sepsis and shock to the concern lady.

Criminal Abortion

It is an illegal abortion committed against the law. The punishment of such abortion is imprisonment. They are mostly done by unqualified persons using the vagina route. The dangers of such abortion include laceration, and perforation of the uterus. Deaths in most cases here are as a result of sepsis shock, and uncontrolled bleeding.

Therapeutic abortion

This is the evacuation of the uterus by unqualified medical health personnel in order to save the mother especially when pregnancy becomes dangerous. It is done in a recognised hospital after husband and wife have given their consent.

Septic abortion

This is an abortion induce criminally using septic materials. It usually results to incomplete abortion and the consequence is death, infertility.

Signs and symptoms of septic abortion

• Lochia is offensive and profuse
• Bp is low but pulse is rapid
• There is high temperature
• There is abdominal pain
• Tender and engorged uterus

Management

• Avoid any vagina disturbances unless bleeding is persistent
• Administer broad spectrum antibiotic
• Blood transfusion may be done in some cases
• Other lab investigation to know the causative factor

Threatened abortion

This is an abortion where there is slight disturbance, but there is a possibility for the pregnancy to go to term. Bleeding and pain are not severe cervical os is closed and membrane are intact, though there may be slight placenta separation. In some cases of threaten abortion, the abortion may become in evitable especially when there is continuous bleeding and painful uterine contraction present.

Missed abortion can also occur, which is a condition where the foetus die and is retain in the uterus.

Treatment of threaten abortion

• Give good bed rest to patient
• All vagina discharges on pad, cloth llin etc should be examine
• Vital signs should be taken twice daily
• Specimen examination should be done to determine any problem in the vagina
• Avoid sexual intercourse for at least 4 weeks to avoid cases of incompetent cervix
• Give some pain killers, antipyretics and other infusion to patient

Inevitable abortion

This is an abortion which the pregnancy cannot continue to term. The placenta usually separate from the uterine wall, there is uterine contraction accompany by lower abdominal pain.

There is membrane rupture with cervical os dilated

Abortion Treatment

1. Give egometrine 0.5mg i.m
2. Give analgesic for pain
3. D and C is done in the hospital to completely clear the uterus
4. Give blood transfusion if there is profuse bleeding occur
5. Inspect all vagina discharges before discarding them.

Missed abortion

It is an abortion which occur when the foetus die and is retained in utero. Breast become soft and signs of pregnancy disappears. Management usually include reassuring of the patient of her condition, refer to the hospital and lastly, administer infusion.