Complete Abortion

Subject: Midwifery I (Theory)

Overview

Complete abortion occurs when the products of conception are fully evacuated from the uterus. Lower stomach pain, vaginal bleeding, and a soft cervix are some of the signs and symptoms. An ultrasound confirms that the abortion was completed completely. If there is a doubt about the entire ejection of a product, we manage the total abortion by doing MVA.

Complete abortion occurs when the results of conception, such as blood, tissue, and embryo, are fully ejected from the uterus and the uterine cavity becomes empty.

Signs and Symptoms

  1. A varied period of amenorrhea's history.
  2. Lower abdominal discomfort
  3. Vaginal hemorrhage with product passage, followed by a reduction in bleeding and pain
  4. Vaginal discharge that generally goes away after a week
  5. When there is significant vaginal bleeding, the patient may experience circulatory collapse or shock.
  6. During a vaginal examination
  7. The cervix is soft, and the internal OS is shut.
  8. The uterus is smaller and bulkier.
  9. There is very little vaginal bleeding.
  10. The entire gestational sac may be observed lying in the vagina. The ejected tissue is determined to be intact.

Investigation

  1. The uterine cavity is empty and the abortion is complete, according to ultrasonography.
  2. A blood test is performed to rule out anemia.

Management

  1. Sedatives, haematinics, tetanus toxoid, anti-D, and methergine are commonly used in treatment.
  2. Usually, uterine evacuation is not required. However, if there is any concern about the completeness of the abortion, manual vacuum aspiration can be performed.
  3. Keep an eye out for indicators of severe bleeding.
  4. Ensure that the patient is followed up on after treatment.
  5. A check curettage may be required in rare cases, and the doctor should be consulted to ensure that the curettage is complete or not.

References

  • Tuitui R. 2002, A textbook of Midwifery A (Antenatal), 3rd edition, Vidyarthi Pustak Bhnadar (Publisher and Distributor), Bhotahity, Kathmandu
  • SlideShare. https://www.slideshare.net/crisbertc/types-of-abortion
  • Prezi. 17 February 2011. https://prezi.com/7avru5nzs1en/types-of-abortion-management-nurses-perspective/
  • NCBI. 22 June 1930. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC381898/?page=3
  • NYTimes. 14. March 2017. http://www.nytimes.com/health/guides/disease/abortion-threatened/overview.html
Things to remember
  • The products of conception like blood, tissue, and embryo are expelled completely from the uterus and the uterine cavity gets empty is called complete abortion.
  • Vaginal bleeding with the passage of products followed by a decrease in the bleeding and pain
  • When there is substantial vaginal bleeding the patient may be in a state of circulatory collapse or shock
  • Sedatives, haematinics, tetanus toxoid, anti-D, and methergine are given
  • Evacuation of the uterus is usually not necessary. But if there is a doubt of complete abortion then manual vacuum aspiration can be performed.
Questions and Answers

Complete abortion refers to the expulsion of all fetal tissue, blood, and embryo from the uterus, leaving the uterine cavity empty.

 

Complete Abortion

It is referred to as a complete abortion when all of the uterus's fetus's tissues, blood, and embryo are completely expelled, leaving the uterine cavity empty.

Signs and Symptoms

  • History of an irregular amenorrheic period.
  • Lower-back soreness
  • Vaginal bleeding that is followed by a reduction in pain and bleeding after the passage of products.
  • Vaginal discharge that often goes away within a week.
  • If the vaginal bleeding is severe, the patient may be in shock or circulatory collapse.
  • On examination of the vagina.
  • The internal OS is closed, and the cervix is soft.
  • Smaller and slightly bulkier than the uterus.
  • Little vaginal bleeding occurs.
  • It's possible to see the entire gestational sac lying in the vagina.
  • Examining the expelled fleshy revealed no damage.

Investigation

  • The uterine cavity is empty and the abortion has been successfully terminated, according to ultrasound.
  • Anemia-confirming blood test

Management

  • Treatment is often conservative and includes the administration of sedatives, haematinics, tetanus toxoid, anti-D, and methergine.
  • In most cases, uterine evacuation is unnecessary. But manual vacuum aspiration can be done if there is any uncertainty about a complete abortion.
  • Keep an eye out for any signs of severe bleeding.
  • After treatment, make sure the patient gets follow-up care.
  • Rarely, a check curettage may be required to ensure that it was successful or not.

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