Incomplete abortion – This course is designed to understand the care of pregnant women and newborn: antenatal, intra-natal and postnatal; breast feeding, family planning, newborn care and ethical issues, The aim of the course is to acquire knowledge and develop competencies regarding midwifery, complicated labour and newborn care including family planning.
Incomplete abortion
When part of the product of conception remains within uterus, it is called incomplete abortion.
or
In an incomplete abortion, parts of the fetus or placental material stay inside the uterus.
The management of incomplete abortion
A. Clinical features:
a) Symptoms:
1. Amenorrhea
2. Persistent PV bleeding in varying amount
3. H/O passage of product of conception (partial)
4. Others:
- Size of uterus may reduce
- There may be pain (may severe)
b) Signs:
1. G/E: Anemia, tachycardia, hypotension
2. P/A: Uterine height not correspond with the age of gestation
3. P/V:
- Os open,
- Product is felt or hanging
B. Investigation:
a) Blood:
- TC, DC, ESR, Hb%,
- Blood groping,
- Rh typing and
- cross matching
b) USG
c). Urine for albumin and sugar
C. Treatment of incomplete abortion:
a) General
1. Hospitalization
2. Assessment of vital signs
3. Immediate resuscitation of the patient by bed rest
- IV infusion (plasma, hematocrite, Hartman’s solution etc)
- Analgesic: Inj. pethidine
- Blood transfusion (if needed)
- Antibiotics – Amoxicillin + Metronidazole
4. Send:
- The blood for Hb%, grouping and cross matching, TC, DC
- Urine for albumin & sugar
b) Specific:
1. Cervix is open: Evacuation and curettage under sedation by pethidne and phenoiarbitone. Any material removed must be sent for histo-pathology. If not possible-Dilatation evacuation and curettage
2. Inj. ergometrin after emptying uterus. 3. Anti D Ig in Rh (-ve) motherl
4. Psychological support and advice for follow up examination
- Contraception if necessary
- Three normal periods before embarking on another pregnancy
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