Management of incomplete abortion ppt Chapter 5: Pain Management Background 5-1 Goal of Pain Management 5-1 Types of Pain 5-2 Pain Management Techniques 5-2 Local Anesthesia 5-4 Complications of Local Anesthesia 5-5 How to Administer Paracervical Block 5-7 Chapter 6: Treatment of Incomplete Abortion Background 6-1 Manual Vacuum Aspiration 6-1 MVA Instrument Kits 6-2 Septic abortion could also arise from an incomplete abortion that was secondarily infected due to an open cervical os. However, after initiation of medical management of incomplete abortion, she had increased per vaginal bleeding with hypotension and bradycardia. 09, 1. The document discusses medical management as an option for miscarriage. Feb 1, 2011 · The options for management of an incomplete miscarriage have included surgical intervention (e. normal saline, ringers lactate • If necessary Check Hb, grouping and cross matching and arrange for blood donor • Give antibiotics to treat infection in case of septic abortion. Symptoms and signs of septic abortion typically appear within 24 to 48 hours after abortion and are similar to those of pelvic inflammatory disease and often those of threatened or incomplete abortion. [2] A viable Aug 25, 2014 · Miscarriage. Incomplete abortion or any abortion performed under unhygienic environment can become septic. 27] were associated with unfavorable management outcome of incomplete abortion. Evaluation shows the การแท้งไม่ครบ (incomplete abortion) หมายถึง การที่มีบางชิ้นส่วนของการตั้งครรภ์หลุดออกมาจากมดลูกก่อนอายุครรภ์ 20 สัปดาห์ โดยที่ยังมีบาง management of the incomplete abortion [AOR = 3. More recently, misoprostol has been shown to be as effective as vacuum aspiration in the management of incomplete abortion [18]. A second and equally important aspect of good postabortion care is the positive attitude of health providers. An incomplete abortion, marked as the most common complication, was observed in 57% of all medical abortions. 36b. Dr Mariem Gweder DHR MSc MRCOG DOGUS. On examination, she is found to have an incomplete miscarriage. Threatened abortion -take proper hx -do proper PE and make diagnosis -give simple analgesics, avoid strenuous activities + sexual intercourse and encourage bed rest. Once these steps have been taken the condition usually improves and the patient can safely be transferred to hospital. This study has given us info … Objectives: This study aimed to compare the efficacy of oral misoprostol with manual vacuum aspiration (MVA) in first trimester incomplete abortions. • Rest—Patient should take adequate rest and to avoid strenous activities, intercourse and traveling. viii Abortion care guideline implementing organizations who provided feedback on the draft guidelines: Bethan Cobley (MSI Reproductive Choices, United Kingdom), Rasha Dabash (Ipas, USA), Eva Lathrop (Population Services International, USA), Steve Nov 18, 2024 · The rate of complications shot up from 4. The most common presenting symptom in patients with CHM i … Abortion between 12 and 20 weeks gestation. 2005 Sep. May 29, 2024 · This topic will discuss the clinical presentation, evaluation, and management of patients with septic abortion. The embryo is dead with the products of conception either intact or expelled. Definition. Most patients with incomplete abortion present at emergence department with shock, this will commonly be due to sepsis, hypovolemia, or haemorrhage. Aug 2, 2022 · Case presentation: A 42-year-old Gravida 3 Para 2 Living 2 with Gestational age of 12 weeks presented with vaginal spotting for 2 days. Participants … Jul 1, 2011 · Septic abortion: Incomplete abortion associated with ascending infection of the endometrium, parametrium, adnexa uteri, or peritoneum: Findings consistent with incomplete abortion: Threatened abortion Medical abortion care encompasses the management of various clinical conditions including spontaneous and induced abortion (both viable and non-viable pregnancies), incomplete abortion and intrauterine fetal demise, as well as post-abortion contraception. Jul 18, 2021 · MVA is the method of choice for the management of incomplete or inevitable abortion for gestation of 14 weeks or less, because it has fewer complications compared to curettage. 6% in 2019. Medical management of miscarriage. Medical abortion care encompasses the management of various clinical conditions including spontaneous and induced abortion (both viable and non-viable pregnancies), incomplete abortion and intrauterine fetal demise, as well as post-abortion contraception. Moderate to severe vaginal Adapted from World Health Organization (WHO). When deliberate steps are taken to end a pregnancy, it is called an induced abortion . Management of uncomplicated spontaneous abortions depends mostly on patient preference. 5mg intramuscularly. d) Incomplete abortion- this is when part of the products of conception, usually the foetus is passed while the placenta and membranes are retained in the uterus. Unsafe abortion may increase the risk of incomplete abortion. In about 15 cases per 100 medical management is not completely effective in which case you would be offered repeat treatment or surgical management. Pregnancy loss at 20 weeks gestation. The medical management is identical in both 16 Surgical management SAB/EPF Options for Therapeutic Abortion: Aspiration Versus Medication Surgical management SAB/EPF Electric Vacuum Aspirator Electric vacuum aspirator Uses an electric pump or suction machine connected via flexible tubing Talking Points To perform an electric vacuum aspiration (EVA) procedure, a cannula of appropriate size (depending on uterine size) is inserted into the Feb 12, 2024 · A pregnancy loss or "miscarriage" generally is defined as pregnancy failure before 20 weeks of gestation. Haemorrhage affects about 2 in 100 women, the same as for natural miscarriage. Unsafe abortion is defined by the World Health Organization (WHO) as an abortion performed by people lacking the necessary skills or in an environment Apr 15, 2024 · Management of Interstitial Ectopic Pregnancy in a Bicornuate Uterus Simulating an Incomplete Abortion Monitoring Editor: Alexander Muacevic and John R Adler Dionysios G Galatis , 1 Christos Benekos , 2 Konstantina Kalaitzi , 2 Panagiotis-Konstantinos Karachalios , 2 Ioannis Chatzipanagiotis , 2 Ippokratis Diamantakis , 2 Foteini Anifantaki , 2 For inevitable, incomplete, or missed abortions, treatment is waiting for spontaneous passage of products of conception, management with medications, or uterine evacuation. until expulsion of POC occurs Evacuate any remaining products of conception from uterus by evacuation and curettage If necessary, give misoprostol 200 mcg vaginally every 4 hours until expulsion, but do not administer more than 800 mcg. Molar pregnancy is composed of two separate entities, partial (PHM) and complete (CHM), which are distinct in terms of epidemiology, genetics, histopathology, clinical presentation and risk of persistent gestational trophoblastic tumor (GTT). of WHO concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. 6 Medical abortion: >12 weeks (or >84 days) of pregnancy 34 2. Options for management of incomplete abortion include surgical and medical methods of uterine evacuation. ) For women with incomplete spontaneous abortion, expectant management for up to two weeks usually is successful, and medical therapy provides little additional benefit. Management of related uterine infections, including intraamniotic infection, postpartum endometritis, and pelvic inflammatory disease (PID), are discussed elsewhere. 25 Infection/Sepsis Initial Treatment. 2% between 2008 and 2015. Feb 12, 2024 · The term "incomplete miscarriage," also known as an "incomplete pregnancy loss" or "incomplete spontaneous abortion," is generally defined as a specific subtype of miscarriage in which the products of conception (POC) have not been completely expelled from the uterus. Spontaneous. 5 Medical abortion: 12 weeks (or 84 days) of pregnancy 29 2. For incomplete abortion at < 14 weeks: Recommend either vacuum aspiration or medical management. Schreiber CA, Creinin MD, Atrio J, Sonalkar S, Ratcliffe SJ, Barnhart KT. 31) and misoprostol therapy (RR 1. The evidence of a trend towards low cost technology is promising, albeit limited to tertiary centres. Jun 16, 2023 · Incomplete abortion. 36a. What did this study nd? Rates of operative spontaneous abortion management decreased from 34. Oct 27, 2024 · Inevitable abortion, incomplete abortion, or missed abortion. Epidemiology • The true incidence of spontaneous abortion is not clearly known but at least 15- 20% of all pregnancies end in spontaneous abortion. xml ¢ ( ÌšËr›0 †÷ é;0l; n’vlg‘´«^2“ô T8¶Õ€¤J²c¿} Ø. It implies delivery of all or any part of the products of conception, with or without a fetus weighing less than 500g. , curettage, vacuum aspiration) to remove retained conception tissue, medical treatment with Incomplete abortion: 35 and 36 (CS) 35. PK !Ñ~óÃé ¤( [Content_Types]. For the medical management of incomplete abortion at < 14 weeks uterine size: Suggest the use of 600 μg misoprostol administered orally or 400 μg misoprostol administered sublingually. Check vital signs. The cervix is already dilated and there is presence of vaginal bleeding . Incomplete Aug 7, 2014 · It discusses the causes, signs and symptoms, and general management of abortion. Do a sterile vaginal examination and remove any placental tissue distending the cervix with a finger or sponge forceps Give ergometrine 0. Spontaneous abortion is commonly referred to as miscarriage and can be threatened, missed, inevitable complete or incomplete. An incomplete abortion occurs when the products of conception are lost in the first 20 weeks of pregnancy. Feb 12, 2024 · In an incomplete pregnancy loss, though the cervical os is also open and vaginal bleeding and cramping are also present, there is partial, but not yet complete, expulsion of the POC. 8 Drugs, supplies and equipment for surgical abortion 40 2. Mar 12, 2019 · 5. General management of abortion cont’ Incomplete abortion. Vaginal bleeding or rupture of the membranes before 20 weeks gestation accompanied by advanced dilation of the cervix. Although morbidity and mortality from septic abortion are infrequent in countries in which induced abortion is legal, suffering and death from this process are widespread in many developing countries in which abortion is either Feb 27, 2016 · A 28-year-old woman presents with a missed abortion. General management of abortion cont’ • MVA is the Feb 12, 2024 · It is also possible for an induced abortion to result in incomplete passage of POC, similar to a spontaneous incomplete miscarriage. M±M"4Ç u9¿> øu¸Œ¯×Eî@*ÊÙÄ ‚¡ï KyFÙ Aug 8, 2021 · Definition Abortion is the ending of a pregnancy by removal or expulsion of an embryo or fetus An abortion that occurs without intervention is known as a miscarriage or "spontaneous abortion" and occurs in approximately 30% to 40% of pregnancies. Incomplete abortion is a pregnancy that is associated with vaginal bleeding, dilatation of the cervical canal, and passage of products of conception. 1994. In the first trimester , expectant management is an option, but this approach is not recommended during the second trimester due to limited safety studies and risk of Septic abortion, an infected abortion complicated by fever, endometritis, and parametritis, 1 remains one of the most serious threats to women’s health worldwide. It is useful to share insightful information on Incomplete Abortion Missed Abortion This PPT slide can be easily accessed in standard screen and widescreen aspect ratios. Why does this study matter to clinicians? With knowledge translation of study results there Aug 12, 2012 · Higher success rates were associated with Incomplete miscarriage (70–96% success rate) High-dose misoprostol (1200–1400 micrograms), Prostaglandins administered vaginally and clinical follow-up without routine ultrasound. May 11, 2018 · This document presents a case of a 29-year-old woman who is 3 months pregnant and experiencing bleeding and abdominal pain. CLINICAL FEATURES • History of passage of fleshy mass per vaginum • Continuation of pain in lower abdomen • Persistence of pv bleeding • Uterine size is smaller After receiving nursing interventions, the patient will be able to understand their condition and complications, manage their care, and identify lifestyle restrictions. 14, 95%CI 1. It outlines protocols for using misoprostol alone or with mifepristone for first and second trimester miscarriages. Treatment of septic abortion is intensive antibiotic therapy plus uterine evacuation as soon as possible. Complete abortion, Incomplete abortion, Missed abortion, Recurrent abortion, Induced abortion Risk factors, etiology, mechanism, clinical manifestations of each type Management –medical & surgical Nursing management Apr 30, 2024 · Inevitable/Imminent abortion. Clinical Management of Abortion Complications A Practical Guide. Look for complications, especially infection. In order to optimise clinical management of this common condition, it is important to establish whether the use of medical treatment (drugs), or expectant management (no routine treatment) may offer a safer alternative for women with incomplete miscarriage, and whether there are specific circumstances where one type of treatment plan is The management of incomplete abortion remains a problem in South Africa, a low income country that is still managing a common clinical problem with costly interventions. The incidence of abortion Oct 14, 2022 · Suction aspiration (RR 1. Expectant management (option for women ≤ 12 weeks gestation) [2] Watchful waiting as long as patient remains stable (i. Oct 21, 2014 · Management of Inevitable abortion • Resuscitation: IV fluids: RL, NS • Blood grouping & Cross matching • Evacuation • MVA for GA < 12/40 • Augment if the GA > 12/40 • Oxytocin • If some PoC remain after abortion manage like incomplete abortion. Vaginal bleeding occurring before 20 weeks gestation without cervical dilation. 2% to 8. A randomized trial of misoprostol compared with manual vacuum aspiration for incomplete abortion. Jun 15, 2018 · Management of abortion Depends on type of abortion and GA. e. This PowerPoint slide showcases three stages. WHO definition: loss of an embryo or fetus weighing 500 grams or less, (20 to 22 weeks or less. Mifepristone Pretreatment for the Medical Management of Early Pregnancy Loss. Misoprostol is included on the WHO Essential Medicines List for the management of incomplete abortion. , no fever or significant hemorrhage) [2] [4] Mar 21, 2019 · The document discusses common causes of abortion in the first and second trimesters such as genetic factors, infections, endocrine disorders, and anatomical abnormalities. The graph below shows the frequency of incomplete abortion as a complication in medical abortions from 2008 to 2015. Food and Drug Administration (FDA) approval of mifepristone (Mifeprex) in 2000. Initial examination she was conscious with normal vital signs. 47, 95% CI = 1. 7 Surgical abortion: cervical preparation 37 2. Patients could also present with severe unexplained pelvic or abdominal pain. Inevitable. What are the risks? Infection affects about 1 - 4 women in every 100. How management of incomplete and missed spon-taneous abortion in Calgary EDs has changed over time. 4 Medical abortion 28 2. Complete abortion, Incomplete abortion, Missed abortion, Recurrent abortion, Induced abortion Risk factors, etiology, mechanism, clinical manifestations of each type Management –medical & surgical Nursing management Apr 30, 2024 · Inevitable/Imminent abortion. Aug 22, 2014 · General management of abortion cont’ • Put up intravenous fluids if the woman is bleeding severely i. Induced abortion can be therapeutic when performed by a doctor for medical reasons, or criminal when illegally procured. WHO Geneva. 9 Surgical abortion: 12–14 weeks of pregnancy 42 Nov 17, 2013 · It defines abortion as the expulsion of an embryo or fetus weighing less than 500g before 24 weeks of gestation. Management If pregnancy <12 wk GA Pt presents with Hx of ammenorhoea Vaginal Bleeding - Scanty to Moderate brownish Lower Abdominal Pain of varying degrees Cervix is partially open with partial expulsion of POC Uterine size is smaller than expected GA Incomplete Abortion Abortion process has started but some parts of POC are still in the uterine cavity Evacuate the uterus via MVA Weeks A, Alia G, Blum J, et al. SPONTANEOUS ABORTION Spontaneous abortion is the most common complication of pregnancy and is defined as the passing of a pregnancy prior to completion of the 20th gestational week. Methods: This randomised controlled trial study was conducted at the University of Ilorin Teaching Hospital, Ilorin, Nigeria between April 2014 and November 2015. 80% of spontaneous abortions occur prior to 12 weeks' gestation. N Sep 16, 2020 · This will influence further management. Threatened. 106(3):540-7. 07–11. [QxMD MEDLINE Link]. S. • 80% o in the first 12 weeks and the rate decreases rapidly thereafter • More than 50% of all conception losses in the first 12 weeks are due to chromosomal anomalies of the zygote, embryo, early fetus or at times the placenta Apr 15, 2021 · Medication management of early pregnancy loss and medication abortion has become increasingly common since the U. Usually, the cramps are intense, and the vaginal bleeding is heavy. Obstet Gynecol. Patients diagnosed with incomplete abortion were included if they chose to continue medical treatment after relevant contraindications were excluded. Adapted from World Health Organization (WHO). Management of Incomplete Abortion Greater than 12 weeks: Infuse oxytocin 40 units in 1 L IV fluids at 40 drops/min. Hinshaw HKS. Medical management of abortion generally involves either a Medical management of abortion Principles underlying the process of improving the access to and quality of abortion care include the right of access to relevant evidence-based health information, so that individuals who can become pregnant can have control over and decide freely and responsibly on matters related to their sexuality and Feb 11, 2008 · This module begins with an explanation of abortion, including the types of abortion, the effect of abortion on maternal mortality and morbidity, the prevention of unwanted pregnancy, laws and regulations related to abortion, sociocultural and religious perspectives, and the role of midwives in abortion care, with particular emphasis on Incomplete abortion: more or less severe bleeding, abdominal pain, uterine contractions, expulsion of products of conception, open cervix. MANUAL VACUUM ASPIRATOR. Vaginal administration of misoprostol is most effective. (See "Clinical chorioamnionitis". 4. It becomes an emergency when it is incomplete, septic, or c severe h’rrage. When patients are allowed to Oct 31, 2018 · 4. 2 In addition to having access to the drug, staff at all healthcare facilities should be trained and provided with equipment to treat incomplete abortion through re-evacuation of the uterus with vacuum aspiration. This will help the patient make informed choices and cope effectively. Case presentation A 38-year-old current Para 2 Aug 1, 2022 · Bleeding in the first trimester is a common presentation in up to 30 % in early pregnancies and more than 50 % of those will go on to have a normal pregnancy. 2. 2% in 2014 to 22. Jul 31, 2019 · 18. 19, 95% confidence interval [CI] 1. Patients may describe passage of tissue, or the examiner may observe evidence of tissue passage within the Nov 21, 2024 · INCOMPLETE ABORTION • The process of abortion is already taken place but the entire products of conception has not been expelled part of it is felt inside uterine cavity 18. Presenting our Incomplete Abortion Missed Abortion In Powerpoint And Google Slides Cpb PowerPoint template design. abortion usually are mixed. 3 Pain management 25 2. . Background: Incomplete abortion is a major problem that should be effectively managed with safe and appropriate procedures. ) (See "Postpartum endometritis". 03, 1. What are the benefits? Oct 27, 2023 · This study aimed to compare the efficacy of different doses of femoston with expectant management in patients with incomplete abortions. 16 The current Ministry of Health policy in Expanding health worker roles for safe abortion in the first trimester of pregnancy 5 Medical management of uncomplicated incomplete abortion WHAT? Management of uncomplicated incomplete abortion (i. Do not give anything by mouth . [1] A threatened miscarriage also called a "threatened abortion" or "threatened early pregnancy loss," typically refers to vaginal bleeding and uterine cramping in an otherwise viable pregnancy before 20 weeks of gestation, though more commonly occurring in the first trimester. In many of the countries 9 Midwives are often the key providers of post-abortion care in the first trimester, and mainly consulting physicians if a patient's condition worsens. Introduction Globally, spontaneous abortion occurs in 10 to 15% of conrmed pregnancies, and it is the most frequent complication in pregnancy [1, 2]. proves access to and quality of safe abortion care while reducing its cost [17]. removal of retained products) may be required after induced abortion or after spontaneous abortion. If the fetus is viable ultrasonographically at 8–9 weeks, only 2–3% are lost thereafter and similarly fetal loss is only 1% after 16 weeks of viable fetus. Trauma to the vagina or cervix or the presence of a foreign bodies are strongly suggestive of unsafe abortion. Miscarriage = Spontaneous abortion Spontaneous loss of a fetus before the 24th week of pregnancy. Patients may describe passage of tissue, or the examiner may observe evidence of tissue passage within the Oct 3, 2024 · c) Complete abortion- this is when all products of conception are expelled from the uterus. Abortions can be spontaneous (threatened, inevitable, complete, incomplete, missed, or septic) or induced (legal or illegal). management methods. Read less Apr 7, 2023 · IMMIDIATE MANAGEMENT OF ABORTION contd INCOMPLETE ABORTION contd. Surgical evacuation of the uterus for management of incomplete abortion usually involves vacuum aspiration or sharp curettage. The document then discusses manual vacuum aspiration (MVA) as a procedure to evacuate the uterine contents in cases of incomplete miscarriage. Medical management of abortion generally involves either a Post-abortion care can reduce the morbidity and mortality associated with abortion that was performed unsafely, incomplete abortion and spontaneous abortion (miscarriage). Symptoms and signs (eg, chills, fever, vaginal discharge, peritonitis, vaginal bleeding) typically appear within 24 to 48 hours after an abortion. Jul 1, 2022 · However, after initiation of medical management of incomplete abortion, she had increased per vaginal bleeding with hypotension and bradycardia. Dec 16, 2021 · Introduction: Abortion is a distressing experience that affects the mother in a variety of ways by influencing on emotional status that can finally result in psychological disorders such as depression [1]. Differentiating these two traditional subtypes can be difficult, and they have no significant prognostic or management differences. The interventions include health teaching to increase knowledge of safe maternal care, family planning, and complications of abortion. It also describes the mechanisms, types (threatened, inevitable, complete, incomplete, missed), signs, investigations, management, and complications of abortion. 25) were slightly more effective than expectant management or placebo in achieving abortion completion, however success rates were similar for all management strategies. g. ofjd ftq cqjpuwi ueooc txrpx cwp rwl hbooj yrf hlhpkwh