ABORTION and its types and management.docx
- 1. CLASS TEACHING ON ABORTION (COMPLETE, INCOMPLETE,MISSED ABORTION)
- 2. SUBJECT: Obstetrics and gynecological nursing. UNIT: TOPIC: Abortion (complete,incomplete,missed). DATE AND TIME: NAME OF THE EVALUATOR: Prof. Shanta V. Laxami NAME OF THE STUDENNT: Ms.Mandeep Kaur METHOD OF TEACHING: Lecture cum discussion. LEVEL OF STUDENT: B.Sc. Nursing IV year. AV AIDS: Roller board: Definition of abortion. Chart: Classification of abortion. Pamphlet: Symptoms of abortion
- 3. Black board: Management of complete, incomplete. Missed abortion. Power point: Abortion (complete, incomplete, missed). CENTRAL OBJECTIVE: Helps the students to acquire knowledge and understand about abortion complete, incomplete and missed and to develop desirable attitude and skills in applying this knowledge in day to day practice. SPECIFIC OBJECTIVES:
- 4. INTRODUCTION : Good morning mam and students. before going to my topic. I would like to give a small introduction; you will be knowing that the birth of the baby is the rebirth of women as a mother there are certain condition in the pregnancy is deviated from the normal .It is known as abnormal pregnancy when you are posted in antenatal OPD a antenatal mother complaints of abdominal cramps, bleeding per vagina, severe back pain what will you suspect for .yes it is abortion so today we will see about Complete ,incomplete and missed abortion.
- 5. s.no TIME SPECIFIC OBJECTIVE CONTENT TEACHERS ACTIVITY STUDENT ACTIVITY
- 6. 1. 2. 3min 5min Define Abortion Review the ABORTION DEFINITION: Abortion is the expulsion or extraction from its mother of an embryo or fetus weighing 500 g or less when it is not capable of independent survival (WHO). This 500 g of fetal development is attained approximately at 22 weeks (154 days) of gestation. The expelled embryo or fetus is called abortion. The word miscarriage is the recommended terminology for spontaneous abortion, TYPES OF ABORTION: ABORTION Explaining With roller board Listening
- 7. 3. 3min types of abortion definition of Spontaneous Induced Isolated Recurrent Legal Illegal Threatened Inevitable Complete Incomplete Missed Septic. Definition of complete abortion Complete abortion is a completed miscarriage. Explaining Listening and taking notes
- 8. complete abortion Typically, a history of vaginal bleeding, abdominal pain, and passage of tissue exists. After the tissue passes, the patient notes that the pain subsides and the vaginal bleeding significantly diminishes. The examination reveals some blood in the vaginal vault; a closed cervical os; and no tenderness of the cervix, uterus, adnexa, or abdomen. The ultrasound demonstrates an empty uterus. When the products of conception are expelled en missed , it is called complete miscarriage. CAUSES OF COMPLETE ABORTION ; Congenital Structural Defect: This Asking question Answering
- 9. 4. 3min structural defect may be due to chromosomal aberration or a serious physical defect. Low Progesterone: Progesterone maintains the decidua basalis. If the corpus luteum fails to produce enough progesterone, it would risk the life of the fetus inside the uterus. Rh Incompatibility:The fetus could get rejected from a mother’s body if they have an incompatible Rh. Under nutrition: Lack of nutrients would cause undernourishment to both the mother and the fetus, leading to abortion. Drug:There are drugs which are contraindicated for pregnant women. Ingestion might compromise the fetus and lead to abortion. Infection:In infection, the fetus would fail to Explaining Listening and taking notes.
- 10. 5. 3min grow and estrogen and progesterone production would fall. This would lead to endometrial sloughing, then prostaglandins would be released leading to uterine contractions and cervical dilatation along with expulsion of the products of pregnancy. SYMPTOMS OF COMPLETE ABORTION; Vaginal spotting. Vaginal spotting appearsas small brownish to reddish spots of blood coming out of the woman’s vaginal opening. This usually occurs when the cervix slightly dilates because the woman may have tried to lift heavy objects or mild trauma to the abdomen occurred. Vaginal bleeding. Bleeding is a serious occurrence during pregnancy because it might indicate that the cervix has opened and Asking question Answering
- 11. 6. 10 min products of conception might be expelled. Pain: Cramping/sharp/dull pain in the symphysis pubis. This could occur on both sides and could be caused by trauma or premature contractions that might cause cervical dilation. Uterine contractions felt by the mother. Uterine contractions can be false or true, but either of the two could be alarming during the early stages of pregnancy because it could expel the contents of the uterus thereby leading to abortion. MANAGEMENT OF COMPLETE ABORTION: Transvaginal sonagraphy is useful to see that uterine cavity is empty otherwise evacuation of uterine curettage should be done. Explaining Explaining Listening And taking notes Listening And taking
- 12. Administration of intravenous fluids: Such as Lactated Ringer’s, IV therapy should be anticipated by the nurse as well as administration of oxygen regulated at 6-10L/minute by a face mask to replace intravascular fluid loss and provide adequate fetal oxygenation. Avoid vaginal examinations: The physician would also avoid further vaginal examinations to avoid disturbing the products of conception or triggering cervical dilatation. Dilatation and evacuation:This is to make sure that all products of conception would be removed from the uterus. However, before undergoing this intervention, the physician must be sure that no fetal heart sounds could be heard anymore and the ultrasound must show an empty uterus. Explaining notes Listening
- 13. 7. 8. Dilation and curettage: This is most commonly performed for both complete and incomplete abortions to remove the remainder of the products of conception from the uterus. INCOMPLETE ABORTION DEFINITION OF INCOMPLTE ABORTION: The embryo is dead but some products of conception are still intact. The cervix is already dilated and there is severe vaginal bleeding. An incomplete And taking notes
- 14. 9. abortion involves vaginal bleeding, cramping (contractions), cervical dilatation, and incomplete passage of the products of conception. A woman experiencing incomplete abortion frequently describes passage of clots or pieces of tissue, and reports vaginal bleeding. When the entire products of conception are not expelled, instead a part of it is left inside the uterine cavity, it is called incomplete miscarriage. CAUSES: Sever high blood pressure: High blood pressure can cause problems for mother Asking questions Answering
- 15. 10. and baby during pregnancy, including preeclampsia and premature birth. High blood pressure usually doesn't cause signs or symptoms. FIBROIDS: Women with fibroids may experience tummy (abdominal) pain during pregnancy, and there's a risk of premature labour. ... In rare cases, fibroids can cause miscarriage. Poor muscle tone in the womb. Cervix and uterus problems. Un controlled diabetes . Acute infection such as german measles and mycoplasma. Kidney disease. Autoimmune disease. Trauma to the abdomen. SYMPTOMS OF COMPLETE ABORTION; Explaining Listening And asking douest.
- 16. 11 Continuation of pain in lower abdomen. Persistence of vaginal bleeding. Vaginal spotting or bleeding. Nausea ,vomiting. Abdominal cramping. INTERNAL EXAMINATION REVEALS: Uterus smaller than the period of amenorrhea. Patulous cervical OS often admitting tip of the finger. The expelled mass is found incomplete. Ultrasonagraphy reveals echogenic material within the cavity. MANAGEMENT OF INCOMPLETE ABORTION. Medical management of incomplete abortion can be done. Tablet misoprisol 200ug is used vaginally every 4hours. Explaining Listening
- 17. EARLY ABORTION; Dilation and evacuation under analgesics or general anesthesia is to be done. LATE ABORTION; The uterus is evacuated under general anesthesia and the products are removd by ovum forceps. The uterus is evacuated under general anesthesia and the products are removed by ovum forceps or by blunt curette. In late cases, dilatation and curettage operation is to be done remove the bits of tissues left behind. The removed materials are subjected to a histological examination. Medical management of incomplete miscarriage may be done. Tablet misoprostol 200 μg is used vaginally every 4 hours. Misoprostol may be used to treat women with Explaining Listening and taking notes.
- 18. an incomplete and missed abortion. Incomplete abortion usually is diagnosed when a pregnant woman has an open cervix and has passed some, but not all of the products of conception . Misoprostol is an effective treatment for incomplete abortion. Simple regimens may be as effective as more complicated ones and a single dose of 600 microg should be further evaluated in larger trials. MISSED ABORTION: Listening and taking notes
- 19. A missed miscarriage is when embryonic death has occurred but there is not any expulsion of the embryo. It is not known why this occurs. Signs of this would be a loss of pregnancy symptoms and the absence of fetal heart tones found on an ultrasound. When the fetus is dead and inside the uterus for variable period it is called missed miscarriage or early fetal demise A miscarriage is the spontaneous loss of a fetus before the 20th week of pregnancy (pregnancy losses after the 20th week are called stillbirths). Miscarriage is a naturally occurring event, unlike medical or surgical abortions. Answering
- 20. CAUSES OF MISCARRIAGE INCLUDE: Drug and alcohol abuse Exposure to environmental toxins Hormone problems Infection Overweight Physical problems with the mother's reproductive organs Problem with the body's immune response Serious body-wide (systemic) diseases in the mother (such as uncontrolled diabetes) Smoking SYMPTOMES OF MISSED ABORTION; vaginal bleeding Listening And taking notes
- 21. abdominal cramps or pain discharged of fluid or tissue lack of pregnancy symptoms. Mild to severe back pain (often worse than normal menstrual cramps) Weight loss White-pink mucus True contractions (very painful happening every 5-20 minutes) Brown or bright red bleeding with or without cramps (20-30% of all pregnancies can experience some bleeding in early pregnancy, with about 50% of those resulting in normal pregnancies) Tissue with clot like material passing from the vagina. MANAGEMENT OF MISSED ABORTION; Answering
- 22. Uterus evacuated as soon as possible. A donor should be kept ready. If uterine size is less than 12 weeks ofgestation PGE1 tablets kept in vagina results in spontaneous expulsion without the need of surgical intervention. If more than 12 weeks, 6th or 12th hourly PGE1tablets used vaginally results in spontaneous expulsion or extra amniotic ethacridine acetate.Anti D and antibiotics.
- 23. . Dilatation and curettage operation is to be done to remove the bitsbehind.Dilatation and curettage
- 24. operation is to be done to remove the bits of tissue left behind.