ABORTION

Termination of pregnancy before 20 weeks of gestation or removal of the fetus weighing less than 500 gm is termed as abortion. Abortion can be due to miscarriage or due to medical termination of pregnancy.

Causes of abortion

  1. Infections - Viral infections (rubella, hepatitis virus, cytomegalovirus etc), malaria, Toxoplasmosis may produce abortion in early pregnancy.
  2. Illnesses in the mother such as respiratory disease, heart failure, severe anemia, severe gastroenteritis, high blood pressure, thyroid disorder, long standing diabetes mellitus and chronic kidney diseases are important factors causing abortion.
  3. Injury to the abdomen by blow or fall.
  4. Abnormalities of the uterus or defective sperms.
  5. Chromosomal defects in the fetus may increase the risk of first trimester miscarriage.
  6. Unknown in most cases.

Threatened Abortion:The process of abortion has started but recovery is possible. It presents as bleeding from vagina and pain in the abdomen. Bed rest is the most important treatment advice for threatened abortion. Doctor may prescribe medicines for sedation and relief of pain. Limitation of activities and avoiding heavy work is advised. Sexual intercourse is contraindicated during this period. You should report the doctor if bleeding or pain increases.

Inevitable Abortion:Here the abortion has progressed to a state from where continuation of pregnancy is impossible. Treatment consists of acceleration of the process of expulsion. If abortion occurs before 12 weeks of pregnancy, Suction & curettage is done. After 12 weeks of pregnancy the uterine contractions are accelerated by medications that leads to expulsion of the abortus.

Missed Abortion:When the fetus is dead & retained inside the uterus for more than four weeks it is called missed abortion. It may start as vaginal bleeding followed by persistent brownish vaginal discharge and the symptoms of pregnancy such as breast enlargement, uterine growth etc subside. Ultrasonography picks up missed abortion. If it occurs before 12 weeks of pregnancy, Suction & curettage is done. After 12 weeks of pregnancy the uterine contractions are accelerated by medications that leads to expulsion of the dead fetus.

Septic Abortion:Abortion associated with infection of the uterus is called septic abortion. It is associated with fever, lower abdominal pain & tenderness. An offensive, purulent vaginal discharge is present. In majority of the cases, the infection occurs following illegal induced abortion done by quacks but can also occur after spontaneous abortion. Cervical swab or high vaginal swab is taken to detect the organism. Treatment consists of hospitalization of the patient. Antibiotics, sedatives & painkillers are needed. Blood transfusion may be required. Surgery may be required in case of abscess.

 

Last created on 31-05-2004
Last created on 18-11-2006


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