THREATENED ABORTION

 Threatened abortion is type of abortion without passage of fleshy tissue but with possibility of continuation of pregnancy 

Investigation:-

Blood:- HB,ABO, Rh Grouping 

USG:-  TVS ( Trans Vaginal sonography) Show live 

Urine:-  For immunological test serum progesterone level. 

Treatment:-

Rest short rest at least two weeks 

Restriction of activities 

Diazepam 5 mg (to relief pain)

Avoid coitus 

Anti D gammas globulin 

Limit activities avoid heavy work weight lifting 

Follow Up Care:- Pt is advise to pressure the vulval pad anything expelled out per vaginum for inspection 

End of one week pelvic USG is done for line pregnancy 

Latter is evacuated by suction evacuation 

                        Prognosis Threatened 

  Cases               Cases 

      Pregnancy terminate Pregnancy Continues 

Pre term labors, PP, IUGR

Inevitable abortion:-

Inevitable abortion is the clinical type of abortion where the changes have progressed to a state from where continuation of pregnancy is impossible, Abortion that can’t be presented 

Clinical features:-

History of amenorrhea 

Increase Vaginal bleeding than threatened abortion 

Severe colicky pain 

No tissue is expelled ( She may faint due to heavy blood loss)

Dilated internal os 

Shock due to blood loss 

Tachycardia Hypotension 

Cold clammy skin 

Note: - Pelvic exam internal cervical os dilates admitting index finger concepts is felt by finger frank blood and clots in vagina. 

Compilations:- 

Blood loss  - shock and death 

Infection of concepts and uterus 

Management:-

Maintain strict asepsis in abortion 

Excessive bleeding should be controlled Methargin 0.2 mg 

Intravenous shock condition 

Active Treatment:-

Before 12 weeks: - Dilation & Curettage

Dilation & evacuation 

Suction & evacuation 

After 12 weeks: - Abortion is expelled out by oxytocin 

Drip (10 units in 500 ml of NS) 40-60

Placenta is removed by ovum force if it is retained