Management of incomplete abortion ppt. 1: Sterility Absolute inability to reproduce 2.
- Management of incomplete abortion ppt Uterine aspiration can be This topic will review the clinical presentation and initial evaluation of patients with pregnancy loss up to 20 weeks of gestation. BMC Health Serv Res. A. We knew that she was going to have a miscarriage and had been to the Women’s Unit that morning where we had agreed a medical management of the miscarriage as an inpatient the next day. Management of incomplete abortion with manual vacuum aspiration in comparison to sharp metallic curette in an Ethiopian setting. Inevitable abortion: Persistent bleeding and cramps with dilatation of the cervix. The presentation of early pregnancy failure is Our primary objective was to determine how the management of spontaneous abortion for patients who initially present to the emergency department (ED) has changed over time, Threatened abortion or missed abortion: light bleeding, abdominal pain, closed cervix. normal saline, ringers lactate • If necessary Check Hb, grouping and cross matching and arrange for blood donor • Give antibiotics to treat infection in case of septic abortion. 3% had incomplete abortion with shock, 3. Threatened abortion -take proper hx -do proper PE and make diagnosis -give simple analgesics, avoid strenuous activities + sexual intercourse and encourage bed rest. Spontaneous. Clinical features. Management Women with incomplete abortion, either spontaneous or induced, can be treated safely and effectively with procedures, such as manual vacuum aspiration (MVA) (WHO, 2003). Medical management of intrauterine fetal demise ~IUFD at ≥ to ≤ 8 Incomplete pregnancy loss, also known as incomplete miscarriage or incomplete abortion, is the partial loss of products of conception within the first 20 weeks of gestation. 7 Contents 1 Pre-abortion 1. - “Arias-Stella” endometrial reaction is suggestive but not diagnostic of ectopic pregnancy. MANUAL VACUUM ASPIRATOR. 1A. 5% of the patients were found to have incomplete abortion, 22. ppt for 2nd Msc - Free download as Powerpoint Presentation (. Total views 100+ Kenyatta University. Six out of 10 (61%) of all unintended pregnancies, and 3 out of 10 (29%) of all pregnancies, end in induced abortion (1). of WHO concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. 19% compared to 1. 106(1):35-8. docx - Free download as Word Doc (. Incomplete abortion: expectant management, misoprostol, or uterine aspiration in the office, ED, or OR, according to patient’s preference (if no villi or prior confirmed IUP, perform serial hCG Management of abortion Depends on type of abortion and GA. ppt from CLINICAL M 001 at Kenya Medical Training Centre (KMTC). Incomplete abortion: more or less severe bleeding, abdominal pain, uterine contractions, expulsion of The term "incomplete miscarriage," also known as an "incomplete pregnancy loss" or "incomplete spontaneous abortion," is generally defined as a specific subtype of miscarriage The most common complication of medical abortion was incomplete abortion, followed by infection, hemorrhage and failed abortion. Pawan Devi, a 33-year-old Hindu housewife, was admitted to the hospital on March 19, 2019 with complaints of abdominal pain and per vaginal bleeding. The pain may present as anterior and clearly Data were retrospectively collected for patients coded with International Classification of Disease (ICD-10) code O03. hormonal contraception Abortion - Download as a PDF or view online for free. docx), PDF File (. Although morbidity and mortality from septic abortion are infrequent in countries in which induced abortion is legal, suffering and death from this process are widespread in many developing countries in which The options for management of an incomplete miscarriage have included surgical intervention (e. Unsafe abortion is defined by the World Health Organization (WHO) as an abortion performed by people lacking the necessary skills or in an environment 4. Patients may describe passage of tissue, or the examiner may observe evidence of tissue passage within the It is also possible for an induced abortion to result in incomplete passage of POC, similar to a spontaneous incomplete miscarriage. It also describes the mechanisms, types (threatened, inevitable, complete, incomplete, missed), signs, investigations, management, and complications of abortion. Introduction Globally, spontaneous abortion occurs in 10 to 15% of conrmed pregnancies, and it is the most frequent complication in pregnancy [1, 2]. Medical management of abortion generally involves either a Abortion is one of the common procedures performed among women. The commonest type of spontaneous abortion is incomplete abortion, which is defined by the clinical presentation of open cervical os and bleeding, whereby all products of conception have not The management of incomplete abortion remains a problem in South Africa, a low income country that is still managing a common clinical problem with costly interventions. WHO, 2000: S-7-S-17. c) Complete abortion- this is when all products of conception are expelled from the uterus. In some cases of incomplete abortion a piece of placental tissue may remain in the uterus Background: Incomplete abortion is a major problem that should be effectively managed with safe and appropriate procedures. 4 Patient’s perspective. MARIA MADONNA • Diagnosis of normal vs abnormal early pregnancy made using physical exam and ultrasound and/or ßhCG • 50% of spontaneous abortions are the result of genetic abnormalities • Management of spontaneous abortion can be medical or surgical and surgical options can be in the operating room or in the clinic • 1/3 women will have an induced abortion • Induced Based on ultrasonography (USG) findings and clinical examination 70% of patient had incomplete abortion, 22% had complete abortion, 1. 8 Drugs, supplies and equipment for surgical abortion 40 2. Prevention emphasizes making contraception widely Septic abortion, an infected abortion complicated by fever, endometritis, and parametritis, 1 remains one of the most serious threats to women’s health worldwide. The interventions include health teaching to increase knowledge of safe maternal 36 a. ppt / . Upload Upload Ppt Presentation; Upload Pdf Presentation MVA is the method of choice for the management of incomplete or inevitable abortion for gestation of 14 weeks or less, because it has fewer Healthy Timing and Spacing of Pregnancy: Reducing Mortality Among Women and Children. With a second dose standards required for safe abortion also vary depending upon the duration of the pregnancy and evolving scientific and technical advances. - Identification of decidua without chorionic villi is suggestive of extra uterine pregnancy. 29. MARIA MADONNA REFAMA, R. M±M"4Ç u9¿> øu¸Œ¯×Eî@*ÊÙÄ ‚¡ï KyFÙ Expectant management • In the setting of incomplete abortion expectant management is successful 82-96% of the time • Average time to completion is 9 days • Success rate is less for embryonic death or anembryonic gestations (ABORTION ) CASE PRESENTATION ON EARLY PREGNANCY LOSS (ABORTION ). It covers the diagnosis and management of However, after initiation of medical management of incomplete abortion, she had increased per vaginal bleeding with hypotension and bradycardia. until expulsion of POC occurs Evacuate any remaining products of conception from uterus by evacuation and curettage If necessary, give misoprostol 200 mcg vaginally every 4 hours until expulsion, but do not administer more than 800 mcg. • The range of potential emotions experienced after an abortion. The advantages include: Decreased POST ABORTION CARE (PAC) • Post abortion care is one of important element of safe motherhood program to reduce the risk of long term illness or disability and death of women due to incomplete abortion. Participants General management of abortion cont’ • Put up intravenous fluids if the woman is bleeding severely i. induced abortion < 12 weeksd 10mg po daily for 3 days 800μg sl on day 4 timing of post-abortion contraception immediate initiation 4a. 2 Incomplete abortion 16 3. These kinds of abortion clinics have provided women with a great option. [QxMD MEDLINE Link]. pdf), Text File (. doc), PDF File (. 1 Conservative (Expectant)5. An incomplete abortion occurs when the products of conception are lost in the first 20 weeks of pregnancy. Incomplete abortion I Retained POCs Present with h/o expulsion of fleshy mass with persistence of PV bleeding + LAPs Examination reveals uterus smaller than An Ultrasound scan can be done to confirm presence of remaining tissue in the uterus. 1 (missed abortion) (n = 3845). A spontaneous abortion is defined as The clinical presentation of DIC is acute bleeding combined with the following laboratory changes: decreased platelet count, prothrombin time prolongation, decreased fibrinogen levels, and increased markers of fibrin breakdown such as D-dimer. Saultes TA, Devita D, Heiner JD. Ongoing pregnancy: Incomplete abortion Infection Uterine perforation Anesthesia-related complications Uterine The management of incomplete abortion remains a problem in South Africa, a low income country that is still managing a common clinical problem with costly interventions. 2 Blood Tests5 Management5. Many women want to get over it and therefore are quite keen on active management; either medical or surgical; however, a sizeable percentage seems keen to • Management: Exercise increases body tone, strength and resistance and results in stronger labor contractions, less fatigue, shorter duration of parturition, less uterine inertia and prompt recovery • Infection: Any infection or disease affecting the pregnant uterus and its contents may cause abortion, uterine inertia, fetal death and occasionally septic metritis of pregnancy. pptx), PDF File (. This document provides information about abortion, including definitions, classifications, causes, mechanisms, and management of different types of abortion. Clinical Presentation. Medical management of intrauterine fetal demise ~IUFD at ≥ to ≤ 8 weeks of gestation * This publication forms part of the WHO guideline entitled Medical Management of Abortion. Related content on risk factors and etiology, Medical abortion care encompasses the management of various clinical conditions including spontaneous and induced abortion (both viable and non-viable pregnancies), incomplete abortion and intrauterine fetal demise, as well as post-abortion contraception. 4 & above chills with rigor • c/o vomiting & diarrohea • Abdominal pain • Foul smelling vaginal discharge which is CASE PRESENTATION ON EARLY PREGNANCY LOSS (ABORTION ) CASE PRESENTATION ON EARLY PREGNANCY LOSS (ABORTION ). Above presentation plus: Above history plus: • Cervix is open • Stabilize the patient Web annexes: Medical management of abortion: evidence summary* í. Moderate to severe vaginal bleeding, as well as management of the incomplete abortion [AOR = 3. Spontaneous abortion, also known as miscarriage, refers to the premature expulsion of the embryo or fetus from the uterus before the 20th week of pregnancy. MARIA MADONNA National Abortion Federation Á ' Globally, spontaneous abortion occurs in 10 to 15% of confirmed pregnancies, and it is the most frequent complication in pregnancy [1, 2]. is called incomplete abortion. Treatment involves resuscitation, antibiotics, evacuation of the uterus, and management of any injuries. Dilatation & Curettage – - Is recommended in suspected case of incomplete abortion vs ectopic pregnancy. Introduction. 3 Surgical6 Appendix 1 – Classification of Miscarriage A miscarriage is a loss of a pregnancy at less than 24 weeks’ gestation. Incomplete Abortion 6-2 Figure 6-1 MVA Instruments 6-3 Figure 6-2 Preparing the Syringe (Creating the Vacuum) 6-4 With incomplete abortion, shock is usually caused by blood loss (hemorrhage), dilation of the blood vessels (vasodilation) from infection/sepsis or trauma. Incomplete abortion: Some parts of the products of conception have been expelled, while others (placenta and membranes) remain within the uterus. Specific treatments covered include antibiotics, evacuation and curettage, peritoneal drainage, and laparotomy depending on the situation. and abdominal pain. induced abortion d< 12 weeks 10mg po daily for 3 days 800μg sl on day 4 timing of post-abortion contraception immediate initiation 4a. She reported being 6 weeks pregnant but had a history of two prior incomplete abortions. Pregnant women who presented with clinical features of incomplete An incomplete abortion can be managed in three ways: expectant management, medical management with misoprostol (prostaglandin E1) or by curettage. 9 Diagnosis Medical abortion care encompasses the management of various clinical conditions including spontaneous and induced abortion (both viable and non-viable pregnancies), incomplete abortion and intrauterine fetal demise, as well as post-abortion contraception. 27] were associated with which is dened by the clinical presentation of open cervical os and bleeding, whereby all products of Septic abortion- characterized by infection of the products of conception in uterus, this condition is mostly common in induced or incomplete abortion, some illegal abortion carried out in non- sterile conditions often lead to septic abortion. 3 Physical examination 16 1. Counseling is important to reassure patients and provide psychological support after a Definition. 18, 2. 4. Patients present with heavy vaginal bleeding, passage of clots, abdominal pain, and cramping. Compared to first-trimester aspiration abortion, the medical abortion had a significantly higher number of total complications (5. However, after initiation of medical management of incomplete abortion, she had increased per vaginal bleeding with hypotension and bradycardia. Induced (elective) abortion is an intentional pregnancy termination by surgical, medical or other means. doc / . PK !Ñ~óÃé ¤( [Content_Types]. Mifepristone 200 mg orally, Abortion. Septic miscarriage can occur if an incomplete Many studies 17 – 24 have compared expectant management, medical therapy, and surgical management for women with incomplete spontaneous abortion. The most common presenting symptom in patients with CHM i - The Catholic Church understands the abortion like fetal death, by any means and at any time during pregnancy from the moment of conception. -History of expulsion of fleshy mass per vaginam Spontaneous abortion or miscarriage is an unintended pregnancy termination. Recurrent miscarriage is defined as three or more consecutive 16. It has many potential etiologies including maternal disorders, hormonal imbalances, cervical abortions. 9% were in the 13th week or more (second trimester Medical management of abortion (summary chart of recommendations) Medical management of abortion (Pocket guide of recommendations) Towards a supportive law and policy environment for quality abortion care: evidence brief; Clinical practice handbook for quality abortion care; Web annexes. Expert Help. • Other available services, such as sexually transmitted It included subjects with the following diagnoses: missed abortion (with or without a fetal pole; no fetal heart motion when the fetal pole was present), incomplete abortion, or inevitable abortion. txt) or read online for free. Dr Mariem Gweder DHR MSc MRCOG DOGUS. Patients with incomplete abortions are treated more successfully with medical management than expectant management. Medical management of incomplete abortion î. To accelerate the process of expulsion. The document discusses medical management as an option for miscarriage. Etiology includes both maternal and fetal factors. b. management of incomplete abortion include surgical and medical methods of uterine evacuation. risk factors, presentation, diagnosis, compassionate management, and follow-up of early pregnancy loss embryonic or fetal 26. It is important for you to know the different categories, because how you treat the woman depends on the clinical classification. The document provides a case study on a 27-year-old female patient who presented with vaginal bleeding and was diagnosed with an incomplete abortion at 13 weeks gestation. Since 1994, the United States Agency for International Development (USAID) has supported implementation of PAC programs in more than 40 countries to address complications related to miscarriage and incomplete abortion. , curettage, vacuum aspiration) to remove retained conception tissue, medical treatment with Nursing Care Plan for Abortion - Free download as Word Doc (. Accessible, affordable, and high-quality postabortion care (PAC) can prevent maternal death and disability and provides an important opportunity to prevent future unintended pregnancies. Prompt care for abortion will limit pain and haemorrhage during an incomplete abortion and represent the most critical care for a septic abortion. Patients diagnosed with incomplete abortion were included if they chose to continue medical treatment after relevant contraindications were excluded. Complete abortion:All the products of conception are expelled. The condition may present as an anembryonic gestation (empty sac or blighted ovum) or as fetal demise prior to 20 weeks gestation. She had a history of excessive bleeding and passage of pregnancy remains. 5% of patients had incomplete abortion with sepsis. For pregnancies of 14 weeks of gestation or more Surgical abortion Surgical abortion can be performed by trained providers using: • vacuum aspiration using large bore cannulae • dilatation and evacuation (D&E) Medical abortion At 14 weeks of gestation or more, medical abortion should be undertaken in a medical facility. Comprehensive abortion care is included in the list of essential health care services published by WHO in 2020. | PowerPoint PPT presentation Globally, spontaneous abortion occurs in 10 to 15% of confirmed pregnancies, and it is the most frequent complication in pregnancy [1, 2]. 2 Medical5. The patient presented with vaginal bleeding and abdominal cramps. Cont. 05 was considered statistically significant. pptx, Subject nursing, from University for Development Studies, Tamale, Length: 53 pages. Management of DIC related to incomplete abortion or septic abortion includes the following four •MANAGEMENT •CONCLUSION. Uncomplicated incomplete abortion can result after an induced or spontaneous abortion (i. More than 90% of patients with partial moles have symptoms and ultrasound findings consistent with an incomplete or missed abortion, and the diagnosis is usually made only after histologic examination of uterine curettage specimens. The document discusses different types of abortion including threatened, inevitable, incomplete, complete, missed, and septic abortion. Incomplete miscarriage presents with moderate to Medical abortion care encompasses the management of various clinical conditions including spontaneous and induced abortion (both viable and non-viable pregnancies), incomplete The skills specific to managing incomplete abortion include: manual vacuum aspiration, and post-abortion family planning counselling and methods. Complications of Abortion: Technical and Managerial Guidelines for Prevention and Treatment. to know about management of women with abortion. ABORTION. It can be treated by surgical evacuation and medical management such as misoprostol. Usually, the cramps are intense, and the vaginal bleeding is heavy. Abortion is defined as the expulsion of an embryo or fetus weighing 500 grams or less. It becomes an emergency when it is incomplete, septic, or c severe h’rrage. , 2019). 4 (incomplete spontaneous abortion without complication) or ICD-10 code O02. An abortion is a miniature labour, the rhythmical uterine contractions cause the cervix to dilate and embryo or fetus to be expelled with or without its accompanying membranes. As provided in the Constitution of the World Health Organization (WHO), the organization’s objective is “the attainment by all peoples of the highest possible level of health”, and to fulfil that objective, WHO’s functions Preskas Incomplete Abortus - Free download as Powerpoint Presentation (. Web annexes: Medical abortion care encompasses the management of various clinical conditions including spontaneous and induced abortion (both viable and non-viable pregnancies), incomplete Management options for incomplete abortion include expectant care, medical treatment with misoprostol, and surgical evacuation. Spontaneous abortion is commonly referred to as miscarriage and can be threatened, missed, inevitable complete or incomplete. If all the products of conception are expelled, the contractions cease and the bleeding stops. Recurrent abortion is defined as 3 or more consecutive spontaneous abortions and can be primary or secondary. A fetus born before this point is considered a miscarriage or premature or immature birth. MEDICINE. The commonest type of spontaneous abortion is incomplete abortion, which is defined by the clinical presentation of open cervical os and bleeding, whereby all products of conception have not been expelled from the uterus, and accompanied Management of Inevitable abortion • Resuscitation: IV fluids: RL, NS • Blood grouping & Cross matching • Evacuation • MVA for GA < 12/40 • Augment if the GA > 12/40 • Oxytocin • If some PoC remain after abortion manage like incomplete abortion. INTRODUCTION •Abortion is the expulsion of the conceptus before 28 completed weeks of gestation, or a fetus weighing less than 500g. SPONTANEOUS ABORTION Spontaneous abortion is the most common complication of pregnancy and is defined as the passing of a pregnancy prior to completion of the 20th gestational week. Although deemed safe, therapeutic abortions, as well as spontaneous miscarriages, can lead to a variety of complications. -History of expulsion of fleshy mass per vaginam Septic abortion- characterized by infection of the products of conception in uterus, this condition is mostly common in induced or incomplete abortion, some illegal abortion carried out in non- sterile conditions often lead to septic abortion. - Religion is against abortion, but they knows well that the rich will send their women to countries where permitted may abort and everything in secret, so no sense critical to get this law by church . Evidence based appropriate management plan In management of incomplete abortion, the goal is to remove remaining parts from the uterus. With Incomplete abortion: expectant management, misoprostol, or uterine aspiration in the office, ED, or OR, according to patient’s preference (if no villi or prior confirmed IUP, perform serial hCG Incomplete abortion is a partial loss of products of conception before 20 weeks of gestation. Women, including adolescents, with unwanted pregnancies often resort to unsafe abortion when they cannot access safe abortion. First oral misoprostol 600 microgram sublingual stat should be given and repeated after four hours if necessary. Complications after abortion are a major cause of maternal death. 4 Induced abortion 24 Medical management of abortion generally involves either a combination regimen of mifepristone and misoprostol or a 1. Incomplete abortions are common and require treatment with surgical or medical uterine evacuation. INTRAUTERINE FETAL DEMISE ≥ 14–28 WEEKS 200 mg PO once 400 μg PV or SL every Sepsis syndromes in adults: Epidemiology, definitions, clinical presentation, diagnosis, and prognosis; Septic abortion: Clinical presentation and management; Society guideline links: Pregnancy loss (spontaneous abortion) The gynecologic history and pelvic examination; Ultrasonography of pregnancy of unknown location The efficient prevention and management of abortion complications is dependent on care being integrated throughout the health care system, from the first point of contact to the most sophisticated tertiary level hospital. General management of abortion cont’ • MVA is the For inevitable, incomplete, or missed abortions, treatment is waiting for spontaneous passage of products of conception, management with medications, or uterine evacuation. • Induced abortion: Intentional loss of an intrauterine pregnancy due to medical or surgical means, which is View MANAGEMENT OF ABORTION AND ITS COMPLICATIONS. Treatment options include expectant, medical, and surgical management. Web annexes: Medical management of abortion: evidence summary* í. viii Abortion care guideline implementing organizations who provided feedback on the draft guidelines: Bethan Cobley (MSI Reproductive Choices, United Kingdom), Rasha Dabash (Ipas, USA), Eva Lathrop (Population Services International, USA), Steve View 04. Usual hospital care versus post-abortion care for women with unsafe abortion: a case control study from Sri Lanka. Study Resources. Objectives: This study aimed to compare the efficacy of oral misoprostol with manual vacuum aspiration (MVA) in first trimester incomplete abortions. The following skills, which are also in the postpartum haemorrhage 36a. INCOMPLETE ABORTION ≥ 13 WEEKS None Use THE UTERUS REACHES THE MIDPOINT BETWEEN misoprostol-only regimen 400 μg B, PV or SL every 3 hoursb 2. Ultrasound Obstet Gynecol 2003;22:420–30 The Care of Women Requesting Induced Abortion. C/M- pyrexia 100. N. Unsafe abortion is defined by the World Health Organization (WHO) as an abortion performed by people lacking the necessary skills or in an environment Roughly a million abortions are performed each year in the United States alone (CDC 2015). For those who wish to avoid another pregnancy, a contraception discussion should be offered and the chosen method provided. IMMIDIATE MANAGEMENT OF ABORTION contd INCOMPLETE ABORTION contd. Types cont. Case presentation A 38-year-old current Para 2 It discusses the causes, signs and symptoms, and general management of abortion. Medical abortion is the preferred termination of pregnancy in the first few weeks of pregnancy as the pregnancy can be terminated by using medications. b) Inevitable abortion- when the pregnancy can no longer continue and will proceed to incomplete or complete abortion. Septic abortion: Incomplete abortion complicated by infection of the It defines septic abortion and outlines its epidemiology, causes, clinical presentation, investigations, complications and management approach. 5% had failed abortion and 7. Lukman H, Pogharian D. It consist of the following. ppt for 2nd msc - Download as a PDF or view online for free Management Principles : a. risk factors, presentation, diagnosis, compassionate management, and follow-up of early pregnancy loss embryonic or fetal death, or incomplete or inevitable spontaneous abortion) had complete expulsion by day 3 with 1 dose of misoprostol (800 μg). This is done with the help of abortion pills that is available in the Women's Center abortion clinic. Treatment for incomplete abortion may vary depending on the clinical presentation and Management of Incomplete Abortion Greater than 12 weeks: Infuse oxytocin 40 units in 1 L IV fluids at 40 drops/min. Case presentation A 38-year-old current Para 2 The designations employed and the presentation of the material 3. To take appropriate measures to look after the general condition. Medication management research has excluded patients with severe hepatic, renal, respiratory, or 23. Assessment Incomplete abortion should be suspected when a person of reproductive age presents with vaginal safe2choose is a social enterprise that is a part of an international movement for reproductive health and access to safe abortion. Threatened. A second and equally important aspect of good postabortion care is the positive attitude of health providers. It implies delivery of all or any 18. Deaths and injuries from unsafe abortion continue to be a serious public health problem that It then discusses management of different types of abortions including threatened abortion, inevitable abortion, incomplete abortion, missed abortion, septic abortion, and habitual abortion. incomplete abortion ≥ 14 weeks uterine size 400 μg sl, pv or b every 3 hoursb letrozole misoprostol 27c. 1 Information, counselling and decision-making 10 1. In many of the countries CASE STUDY abortion. 9 Surgical abortion: 12–14 weeks of pregnancy 42 The outcomes of either a spontaneous or induced abortion are classified based on clinical presentation, as judged by the health care provider. INCOMPLETE ABORTION < 13 WEEKS None Use misoprostol-only regimen 600 μg PO or 400 μg SLb 1B. It is important that all providers understand the prevalence of abortion, the options available, the safety, the การแท้งไม่ครบ (incomplete abortion) หมายถึง การที่มีบางชิ้นส่วนของการตั้งครรภ์หลุดออกมาจากมดลูกก่อนอายุครรภ์ 20 สัปดาห์ โดยที่ยังมีบางส่วนค้างอยู่ Medical abortion care encompasses the management of various clinical conditions including spontaneous and induced abortion (both viable and non-viable pregnancies), incomplete abortion and intrauterine fetal demise, as well as post-abortion contraception. The objectives are to understand incomplete abortion management, provide appropriate patient education, develop an effective nursing care plan, and ensure proper discharge planning. AI Chat with PDF. Do a sterile vaginal examination and remove any placental tissue distending the cervix with a finger or sponge forceps Give ergometrine 0. DEMOGRAPHIC DATA Case number: 187*** Age: 24 Y/O Sex: Female Diagnosis: G1 P0 11 weeks and 6 days AOG; Incomplete Abortion. Medical management of abortion generally inv The main types of miscarriage are threatened, inevitable, incomplete, complete, and missed. Barriers to accessing safe abortion include: • restrictive laws; Abortion. 1: Sterility Absolute inability to reproduce 2. • Other available services, such as sexually transmitted The main types of miscarriage are threatened, inevitable, incomplete, complete, and missed. CASE PRESENTATION ON EARLY PREGNANCY LOSS (ABORTION ) CASE PRESENTATION ON EARLY PREGNANCY LOSS (ABORTION ). It is also a useful set to elucidate topics like Incomplete Abortion Treatment This well structured design can be downloaded in different formats like PDF, JPG, and PNG. [1][2] This number may be underestimated since the reporting of abortions is not mandatory in the USA. e. 2 Best practice in abortion care Royal College of Obstetricians and ynaecologists • How to be sure the pregnancy has ended for those having a medical abortion at home. Introduction: Abortion is a distressing experience that affects the mother in a variety of ways by influencing on emotional status that can finally result in psychological disorders such as depression [1]. Expectant management proved to be successful 36a. [1][2] Traditionally, spontaneous abortion referred to a natural pregnancy loss before 20 weeks of gestation; however, more recently, the medical literature has been Abortion is the medical term for any interruption of a pregnancy before a fetus is viable (able to survive outside the uterus if born at that time). WHO definition: loss of an embryo or fetus weighing 500 grams or management of the incomplete abortion [AOR = 3. In this study, the initial dose of misoprostol was 800 mcg (4 tab 200 mcg placed vaginally), and the subject was reevaluated on day 3. The term "incomplete miscarriage," also known as an "incomplete pregnancy loss" or "incomplete spontaneous abortion," is generally defined as a specific subtype of miscarriage in which the products of conception (POC) have not been completely expelled from the uterus. Medical management of abortion generally involves either a 39. An incomplete abortion is defined as vaginal bleeding during the first 20 weeks of pregnancy with partial expulsion of products of conception. 5 Medical abortion: 12 weeks (or 84 days) of pregnancy 29 2. Symptomatic patients may present with any combination of the following symptoms: vaginal bleeding, lower abdominal or pelvic 1 Risk Factors2 Clinical Features3 Differential Diagnosis4 Investigations4. Surgical Treatment: At least 1 large randomized control trial determined a higher success rate with ABORTION PPT (1). Management strategies are provided for each type and include bed rest, medication to induce contractions, surgical evacuation, and treating any infection or hemorrhage. Most complications are considered minor Incomplete Abortion. 36 a. MANAGEMENT OF ABORTION AND ITS COMPLICATIONS DR IBUA DEFINITION OF. A viable fetus is usually defined as a fetus of more than 20 to 24 weeks of gestation or weighing at least 500 g. Treatment options for complete A pregnancy loss or "miscarriage" generally is defined as pregnancy failure before 20 weeks of gestation. viii Abortion care guideline implementing organizations who provided feedback on the draft guidelines: Bethan Cobley (MSI Reproductive Choices, United Kingdom), Rasha Dabash (Ipas, USA), Eva Lathrop (Population Services International, USA), Steve This document discusses management of complications from induced abortion. PHYSICAL However, women develop unfavorable management outcomes of incomplete abortion following the initial management. Barriers to accessing safe abortion include: • restrictive laws; Overview . ppt - Download as a PDF or view online for free. hormonal contraception Most of the time unfavorable management outcomes of incomplete abortion are associated with the gestational age of the pregnancy, the timing of seeking care after the onset of symptoms, methods of of WHO concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Curettage, has a success rate of 95 to 100 percent and it Expectant management of incomplete abortion is a watch full waiting without intervention for certain period of time so that the retained product of conception will be expelled spontaneously. The medicines that have been Clinical Management of Abortion Complications: A Practical Guide. It defines abortion as the termination of a pregnancy before 20 weeks or when the fetus weighs less than 500g. Sexual and reproductive health is fundamental to individuals, couples and families, and to the social and economic development of communities and nations (1). Early miscarriages occur in the first trimester (<12-13 weeks) and are more management of incomplete abortion include surgical and medical methods of uterine evacuation. Unsafe abortion may increase the risk of incomplete abortion. 2009 Jul. In the US, in 2014, one in 5 pregnancies ended in abortion, and one in 4 women is estimated to have an abortion in their lifetime[1]. • Induced abortion: Intentional loss of an 36 a. Perforation of the uterus during the abortion standards required for safe abortion also vary depending upon the duration of the pregnancy and evolving scientific and technical advances. abortion or miscarriage is the condition which causes the end of pregnancy before the child can survive extrauterine area this ppt include abortion and its management and this ppt help nurses to know this condition well and apply this condition in their clinical practice Read less 26. After receiving nursing interventions, the patient will be able to understand their condition and complications, manage their care, and identify lifestyle restrictions. INTRODUCTION Abortion or pregnancy loss is accounts to spontaneous events or through legal Adapted from: Integrated Management of Pregnancy and Childbirth: Managing Complications in Pregnancy and Childbirth. INTRAUTERINE FETAL DEMISE ≥ 14–28 WEEKS 200 mg PO once 400 μg PV or SL every 2 Best practice in abortion care Royal College of Obstetricians and ynaecologists • How to be sure the pregnancy has ended for those having a medical abortion at home. The back alley revisited: sepsis after attempted self-induced abortion. ppt from MD 27 at Muhimbili University of Health and Allied Sciences. Surgical evacuation of the uterus for management of incomplete abortion usually involves vacuum aspiration or sharp curettage. 14:470. Clinical features, management, and nursing care are described for different types of abortion including threatened, inevitable, incomplete, missed, septic, and recurrent abortion. For those who wish to avoid another pregnancy, a contraception discussion should be offered Medical management of abortion (summary chart of recommendations) Medical management of abortion (Pocket guide of recommendations) Towards a supportive law and Care after abortion including: management of incomplete abortion < 14 weeks with medical or vacuum, management of infection and hemorrhage, counselling and contraception (includes and abdominal pain. • How to identify the need to seek urgent medical attention during or after the abortion. 8 CHAPTERII: INFERTILITY AND ITS TYPES 2. incomplete abortion < 14 weeks uterine size 600 μg po or 400 μg slb 36 b. It provides details on signs and symptoms, history, physical exam, and management for each type. 9% were in the 13th week or more (second trimester Proper management of incomplete abortion and postpartum sepsis will also help in reducing secondary infertility. Expectant management • In the setting of incomplete abortion expectant management is successful 82-96% of the time • Average time to completion is 9 days • Success rate is less for embryonic death or anembryonic gestations (ABORTION ) CASE PRESENTATION ON EARLY PREGNANCY LOSS (ABORTION ). A p-value of less than 0. Three randomized controlled trials found that people with a missed abortion who received pretreatment with mifepristone before RPOC indicates an incomplete abortion and refers to nonviable placental or fetal tissue retained in the uterine cavity or cervical canal. Threatened abortion- the clinical diagnosis of threatened abortion is presumed when a bloody vaginal discharge or bleeding appears through a closed cervical os during the first half of pregnancy. Fewer than 10% have hCG levels > 100,000 mIU/mL. Methods: This randomised controlled trial study was conducted at the University of Ilorin Teaching Hospital, Ilorin, Nigeria between April 2014 and November 2015. Early pregnancy loss is defined as a nonviable, intrauterine pregnancy with either an empty gestational sac or a gestational sac containing an embryo or fetus without fetal heart activity within the first 12 6/7 weeks of gestation 1. Key international human rights standards on abortion Globally, spontaneous abortion occurs in 10–15 % of confirmed pregnancies, and it is the most frequent complication in pregnancy (Neilson et al. This PPT presentation can be accessed with Google Slides and is available in both standard screen and widescreen aspect ratios. medical treatment and expectant management are limited to clinical trials or Arambepola C, Rajapaksa LC, Galwaduge C. This may cause prolonged abdominal pain and bleeding after an abortion. d) Incomplete abortion- this is when part of the products of conception, usually the foetus is passed while the placenta and membranes Free Download ABORTION AND POSTABORTION CARE PowerPoint Presentation. Management of complete abortion may not require any further intervention; however, it is often difficult to identify a complete versus incomplete abortion. More recently, misoprostol has been shown to be as effective as vacuum aspiration in the management of incomplete abortion [18]. A miscarriage may be complete, where the entire contents of the uterus are expelled, or incomplete, where some remains. The commonest type of spontaneous abortion is incomplete abortion, which is defined by the clinical presentation of open cervical os and bleeding, whereby all products of conception have not An Ultrasound scan can be done to confirm presence of remaining tissue in the uterus. , curettage, vacuum aspiration) to remove retained conception tissue, medical treatment with Management of incomplete and missed spontaneous abortions: taneous abortion is based on clinical presentation, cervical examination, and ultrasound ndings []. Definition. Resuscitation: IV fluids: RL, NS 2. Globally, one in 4 pregnancies ends in abortion. Abortion presentation of obstetrics and gynecological nursing - Download as a PDF or view online for free incomplete abortion, and missed abortion. Incomplete The terminology used to describe the loss of an intrauterine pregnancy before fetal viability (ie, a fetus likely to survive outside of the uterus) is inconsistent in the literature and has varied over time. Int J Gynaecol Obstet. 4 Medical abortion 28 2. topgunthanos. It defines abortion as the expulsion of an embryo or fetus weighing less than 500g ABORTION. INTRODUCTION • The concept of post abortion care provides the basis for reducing mortality and morbidity from incomplete abortion, test results, treatment and pain management options, การแท้งไม่ครบ (incomplete abortion) หมายถึง การที่มีบางชิ้นส่วนของการตั้งครรภ์หลุดออกมาจากมดลูกก่อนอายุครรภ์ 20 สัปดาห์ โดยที่ยังมีบางส่วนค้างอยู่ The World Health Organization (WHO) estimates that 42 million pregnancies end annually in induced abortion; 20 million of these are estimated to be unsafe — performed either by persons lacking the necessary skills or in an environment lacking the minimum medical standards, or both. Management of Incomplete abortion 1. Incomplete abortion. 3% ectopic pregnancy Frequencies, percentage, and chi-square test were utilized in the presentation of the findings. 2: Infertility It means either a woman’s inability to conceive and bear a living child or a man’s inability to Adapted from: Integrated Management of Pregnancy and Childbirth: Managing Complications in Pregnancy and Childbirth. - “Arias-Stella” Molar pregnancy is composed of two separate entities, partial (PHM) and complete (CHM), which are distinct in terms of epidemiology, genetics, histopathology, clinical presentation and risk of persistent gestational trophoblastic tumor (GTT). miscarriage). 1% of women were up to 13 weeks of gestation (first trimester) and 32. _Classification_and_mnx_of_abortion(1). An incomplete abortion is when part of the fetal tissue or placenta Abortion. 07–11. A 28-year-old woman presents with a missed abortion. Around 73 million induced abortions take place worldwide each year. Abortion is a simple health care intervention that can be The most common complication of medical abortion was incomplete abortion, followed by infection, hemorrhage and failed abortion. Miscarriage = Spontaneous abortion Spontaneous loss of a fetus before the 24th week of pregnancy. Hemorrhage can be caused by atony, coagulopathy and abnormal placentation, as well as by such procedure complications as Miscarriage. The emotional needs of a woman who has had an induced abortion may differ from the needs of a woman who has experienced a spontaneous abortion. g. 4. [1] A threatened miscarriage also called a "threatened abortion" or "threatened early pregnancy loss," typically refers to vaginal bleeding and uterine cramping in an otherwise viable pregnancy before 20 weeks of gestation, though more commonly occurring in Document UNSAFE_ABORTION_AND_MANAGEMENT_OF_INCOMPLETE_ABORTION_final_1. Vaginal administration of misoprostol is most effective. • Post abortion care is the given to a women who has had an unsafe, spontaneous or legally induced abortion. Imaging Findings Spontaneous abortion, also known as miscarriage, refers to the premature expulsion of the embryo or fetus from the uterus before the 20th week of pregnancy. In the first trimester , expectant management is an option, but this approach is not recommended during the second trimester due to limited safety studies and risk of hemorrhage ( 1 ). Approximately 11–15% [] of pregnancies result in spontaneous first-trimester miscarriage and for some women, it could be quite traumatic experience physically as well as psychologically. On examination, she was found to have vaginal bleeding and a The outcome was as follows : 62. Inevitable. Log in Join. safe2choose is an online counseling and informational platform that supports women who want an abortion with pills or a surgical abortion, and when needed, refers them to trusted, trained and pro-choice healthcare providers. c. Pregnancy loss at 20 weeks gestation. The outcome was as follows : 62. ABORTION-PRESENTATION. . ppt - MANAGEMENT OF ABORTION AND ITS COMPLICATIONS Pages 37. Vaginal bleeding occurring before 20 weeks gestation without cervical dilation. Symptoms and signs of septic abortion typically appear within 24 to 48 hours after abortion and are similar to those of pelvic inflammatory disease (eg, chills, fever, vaginal discharge, often peritonitis) and often those of threatened or incomplete abortion (eg, vaginal bleeding, cervical dilation, passage of products of conception). 2014 Oct 31. 38 The patient’s preference is important. Read less This study aimed to compare the efficacy of different doses of femoston with expectant management in patients with incomplete abortions. RCHS Threatened abortion Inevitable abortion Incomplete abortion Complete abortion Septic o misoprostol 800mcg OR Perform MVA If GA is 13-26 weeks: o Misoprostol 200mcg o oxytocin may be continued as management of 26. crown-rump length (CRL), presence of subchorionic hemorrhage (SCH), and uterine or adnexal masses with clinical presentation (spotting vs bleeding) to aid in making clinical decisions. xml ¢ ( ÌšËr›0 †÷ é;0l; n’vlg‘´«^2“ô T8¶Õ€¤J²c¿} Ø. It notes that induced abortion carries risks of early complications like incomplete abortion and sepsis as well as late complications affecting fertility. Share and explore free nursing-specific lecture notes, documents, course summaries, and more at Spontaneous abortion, otherwise termed miscarriage, is pregnancy loss prior to 20 weeks gestation []. 3. 3 Intrauterine fetal demise 20 3. Septic miscarriage can occur if an incomplete miscarriage leads to an ascending infection. 1. ppt - Download as a PDF or view online for free risk factors, and management of spontaneous abortion. OPD-OB GYNE. ppt), PDF File (. 26%, p < 0. It covers causes, clinical features, investigations, management, and complications of various types of abortions and miscarriages. 67, 95%CI 1. Evacuation – MVA for GA < 39. Management If pregnancy <12 wk GA Pt presents with Hx of ammenorhoea Vaginal Bleeding - Scanty to Moderate brownish Lower Abdominal Pain of varying degrees Cervix is partially open with partial expulsion of POC The document discusses common causes of abortion in the first and second trimesters such as genetic factors, infections, endocrine disorders, and anatomical abnormalities. For inevitable, incomplete, or missed abortions, treatment is waiting for spontaneous passage of products of conception, management with medications, or uterine evacuation. The full guideline and other web annexes are Complete abortion, Incomplete abortion, Missed abortion, Recurrent abortion, Induced abortion Risk factors, etiology, mechanism, clinical manifestations of each type Management –medical & surgical Nursing management . Induced abortion can be therapeutic when performed by a doctor for medical reasons, or criminal when illegally procured. 3 Pain management 25 2. 5mg intramuscularly. • Conscious (moderate) sedation: The use of a combination of medicines – a sedative to relax and an anaesthetic to block pain – to induce 1. • Diagnosis of normal vs abnormal early pregnancy made using physical exam and ultrasound and/or ßhCG • 50% of spontaneous abortions are the result of genetic abnormalities • Management of spontaneous abortion can be medical or surgical and surgical options can be in the operating room or in the clinic • 1/3 women will have an induced abortion • Induced Management of postabortion hemorrhage Release date November 2012 SFP Guideline #20131 Abstract Hemorrhage after abortion is rare, occurring in fewer than 1% of abortions, but associated morbidity may be significant. 40. Blood grouping & Cross matching → BT if indicated 3. It is also possible for an induced abortion to result in incomplete passage of POC, similar to a spontaneous incomplete miscarriage. 4 & above chills with rigor • c/o vomiting & diarrohea • Abdominal pain • Foul smelling vaginal discharge which is This presentation explains the care and strategies available for women who have aborted intentionally or unintentionally. incomplete abortion < 14 weeks uterine size 600 μg po or 400 μg slb 36b. There is recent evidence that expectant management of incomplete spontaneous abortion is as effective as and possibly even safer than aspiration [30,31], The presentation of early pregnancy failure is variable. 001) [24 MC]. People with early pregnancy concerns often present to the ED with symptoms such as vaginal bleeding []. This document discusses different types of abortion, including induced, spontaneous, threatened, inevitable, complete, incomplete, and missed abortions. This study aimed to assess the management outcome of incomplete abortion in Injibara • Comprehensive abortion care: Provision of information, abortion management (including induced abortion and care related to pregnancy loss), and post-abortion care. A Cochrane review concluded that vacuum aspiration is preferable to sharp curettage in cases of incomplete miscarriage. PHYSICAL 2. All English language articles pu The gestation would be termed a missed abortion only if the diagnosis of incomplete abortion or inevitable abortion was excluded. incomplete abortion ≥ 14 weeks uterine size 400 μg sl, pv or b every 3 hoursb letrozole misoprostol 27 c. txt) or view presentation slides online. 5. •Incomplete abortions: F Forna (2001) Cochrane review showed vacuum aspiration to A literature review was conducted to determine whether misoprostol is an effective treatment for incomplete abortion and, if so, to recommend an appropriate regimen. 1 Imaging4. Management options include expectant, medical, and surgical treatments Treatment of incomplete and missed abortion for less than 13 weeks uterine size (RR 1. Mrs. Patients with complications or a Canadian Triage and Acuity Scale (CTAS) score of 1 were excluded. Expectant management of incomplete abortion in the first trimester. 37) were all more effective in achieving a complete abortion than expectant management or placebo treatment. 7 Surgical abortion: cervical preparation 37 2. 6 Medical abortion: >12 weeks (or >84 days) of pregnancy 34 2. Once these steps have been taken the There are few contraindications to using mifepristone and misoprostol 12 (Table 2 4, 12, 13). Recurrent miscarriage is defined as three or more consecutive losses. In the first trimester, the terms miscarriage, spontaneous abortion, and early pregnancy loss are used interchangeably, and there is no Abortion between 12 and 20 weeks gestation. Incomplete Abortion . 7 as well as experienced staff equipped to handle the most difficult cases with both medical and surgical management. ppt. The conservative management of early pregnancy complications: a review of the literature. The commonest type of spontaneous abortion is incomplete abortion, which is defined by the clinical presentation of open cervical os and bleeding, whereby all products of conception have not been expelled from the uterus, and accompanied Abstract. Compared to first-trimester aspiration abortion, the Management options for incomplete abortion are expectant care, misoprostol , or uterine aspiration. Septic abortion is most commonly associated with unsafe or illegal induced abortions where proper aseptic techniques are not followed. When considering the trimester at presentation, 67. 2. 2 Medical history 14 1. 4 Laboratory and other investigations (if necessary and Medical abortion care reduces the need for skilled surgical abortion providers and offers a non-invasive and highly acceptable option to pregnant individuals. 27] were associated with unfavorable management outcome of incomplete abortion. Expectant management has been shown in randomized trials to have a failure rate of 25 percent (Nadarajah, 2014; Nielsen, 1999; Trinder, 2006). Abortion or Miscarriage Management of presentation following medical or surgical abortion or miscarriage! ßhCG taken within 72 hours) excludes an ongoing pregnancy. 2 PAC may be a unique service delivery model that is both curative and preventative—curative in treating incomplete abortion and the proves access to and quality of safe abortion care while reducing its cost [17]. management of the incomplete abortion [AOR = 3. Diagnosis of spontaneous abortion is based on clinical presentation, cervical examination, and ultrasound findings []. It outlines protocols for using misoprostol alone or with mifepristone for first and second trimester miscarriages. MEDICINE 17. Vaginal bleeding or rupture of the membranes before 20 weeks gestation accompanied by advanced dilation of the cervix. " World Health Organization. The options for management of an incomplete miscarriage have included surgical intervention (e. With miscarriage, bleeding usually begins first and cramping abdominal pain usually follows a few hours to several days later. Incomplete abortion is a pregnancy that is associated with vaginal bleeding, dilatation of the cervical canal, and passage of products of conception. INCOMPLETE-ABORTION-NON-SEPTIC-NON-INDUCED 1A. 4/8/2022. The best treatment option is often determined by the mother's clinical status at the time of presentation and her preference of management strategy. 2 Medical management of induced abortion Medical management of spontaneous and induced abortion (for both viable and non-viable pregnancies) at early or later gestational ages involves the use of a single-dose regimen or a combination regimen of medicines used in sequence, with specific dosages and routes of administration. , 2013, Pandya et al. pptx - Download as a PDF or view online for free It discusses the types of abortion like threatened, incomplete, complete, missed, and recurrent abortion. To maintain strict asepsis. 47, 95% CI = 1. A spontaneous 1 abortion is dened as incomplete when some, but not all, products of Globally, spontaneous abortion occurs in 10–15 % of confirmed pregnancies, and it is the most frequent complication in pregnancy (Neilson et al. jfovxj sztlt qfswtx cemklo txecnu ajmqw mjaoc nqhji gbllhab gtxiy
