ABORTION

Question 1

~ Interruption of a pregnancy before a fetus is viable

~ Occurs in 15% to 30% of all pregnancies

~ Early or late miscarriage

Answer 1

Spontaneous Abortion

Question 2

Abortion Causes

Answer 2

Chromosomal abnormalities

•Implantation abnormalities

•Increased Progesterone from Corpus Luteum

•Maternal & Intra-abdominal infections

•Endocrine disorders
•Abnormalities of the reproductive system (uterus / cervix)

•Teratogenic drugs

•Ingestion of alcohol

Question 3

~ Unexplained bleeding, cramping or backache

~ Bleeding may persist for days

~ Cervix is closed

~ Evaluation for H. Mole or etopic pregnancy is advisable

Answer 3

Threatened

Question 4

Increased bleeding and cramping, dilated internal cervical os membranes may rupture

“Inevitable abortion”

Answer 4

Imminent

Question 5

~ All the products of conception are expelled

~ Contracted uterus

~ Cervical os may be closed

Answer 5

Complete

Question 6

~ some of the product of conception are retained

~ Slightly dilated internal cervical os

Answer 6

Incomplete

Question 7

~ fetus dies in the utero but its not expelled

~ Uterine growth ceases, breast changes regress, brownish vaginal discharge

~ Cervix is closed

Answer 7

Missed

Question 8

~ Abortion occurs consecutively in three or more pregnancies

~ Habitual abortion

Answer 8

Recurrent

Question 9

~ Presence of infection

May occur with:
~ Prolonged, unrecognized rupture of the membranes

~ Pregnancy with an IUD in utero

Answer 9

Septic

Question 10

Assessment

Answer 10

~ Ultrasound scanning
~ Assess for hemoglobin and hematocrit
~ Assess amount of bleeding and the description, location and severity of pain
~ Blood type and antibody status
~ FHR if 10-12wks or more

Question 11

Procedure performed by knowledgeable health care provider to end pregnancy before viability

•A.k.a. therapeutic, medical, or induced abortions

Answer 11

Elective Termination

Question 12

Reasons for Elective termination

Answer 12

~ Threatens a women’s life
~ Genetic disorders of the fetus
~ Unwanted pregnancy

Question 13

Involve several different techniques, depending on the gestational age

Answer 13

Surgical Elective terminations

Question 14

Menstrual extraction /suction evacuation is preformed at

Answer 14

5-7 weeks AOG

Question 15

Used for less than 13 weeks AOG

Answer 15

D & C

Question 16

Used between 12 & 16 wks. of gestation

•Adm. of buccal misoprostol or insertion of laminaria tent into the cervix

•Antibiotic as prophylaxis

Answer 16

Dilation and Vacuum extraction

Question 17

Used bet. 16-24 weeks of gestation

Answer 17

Prostaglandin or 20% saline induction

Question 18

20-24 weeks of gestation

Answer 18

Hysterotomy

Question 19

Formerly used during the last 3 months of pregnancy

Answer 19

Partial birth abortion

Question 20

Mifepristone (RU-486)
Methotrexate & misoprostol
Antibiotics as prophylactic protection

Answer 20

Medically Induced Termination

Question 21

The uterine cavity is scrapped with a ______ to determine whether any significant amount of tissue remains

Answer 21

Curette

Question 22

Missed abortions:

First trimester:

Beyond 12 weeks gestation:

Answer 22

1.) Abortion by suction or D&C

2.) Induction of labor or D&E

Question 22

Collaborative care

Answer 22

1.) supplementation with folic acid

2.) Rh Immune globulin (RhoGAM) is given within 72 hours (Rh-mother and not sensitized)

3.(Bed rest and absence from coitus

3.)