Abortion
Abortion
Abortion
• INCIDENCE: 10-20%
CAUSES OF ABORTION
Fetal cause Maternal cause
Genetic factors Infections: rubella,CMV,malaria,brucella.
FIRST TRIMESTER: (aneuploidy,trisomy) leads to Medical disorders: Hypertension,chronic renal
50% cases of abortion. disease, cyanotic heart disease.
Endocrine problems: hypothyroidism,poorly
controlled diabetes mellitus,PCOD,LPD
Immunological: APLA syndrome, Inherited
thrombophilias.
Environmental factors: Alcohol,
smoking,exposure to radiation.
Unexplained.
Incomplete abortion:
Medical management of incomplete miscarriage may be done. Tablet
Misoprostol 200 µg is used vaginally every 4 hours.
Surgical management: dilatation and evacuation.
Missed abortion:
Before 12 weeks:
(1) Dilatation and evacuation followed by curettage of the uterine cavity by blunt
curette.
(2)Suction evacuation followed by curettage.
After 12 weeks:
(1) The uterine contraction is accelerated by oxytocin drip.
(2) The fetus is expelled and the placenta is retained, it is removed by ovum
forceps, If the placenta is not separated, digital separation followed by its
evacuation is to be done.
• Methods of performing medical termination of pregnancy are:
Medical Misoprostol
Mifepristone Dilatation and evacuation using ovum
Misoprostol(PGE1) forcep
Methotrexate Intrauterine instillation of hyperosmotic
solutions
Oxytocin infusion.
Hysterotomy
Surgical
Menstrual regulation
Manual vacuum aspiration
Suction and evacuation
Dilatation and curettage
Recurrent abortion