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Module 5 - Abortion

Abortion

QuestionAnswer
Causes of Bleeding first & second trimester Abortions; Ectopic pregnancy; Gestational trophoblastic disease
Causes of Bleeding Third trimester Placenta previa; Abruptio placentae
Abortion Definition Expulsion of the fetus b4 viability, which is 20 weeks gestation or 500 g
Abortions Spontaneous AKA miscarriage (occurs naturally)
Abortions Induced artificial or mechanical interruption
Threatened Embryo or fetus is jeopardized by unexplained bleeding, cramping and backache. Bleeding may persist for days. May be followed by partial or complete expulsion of embryo or fetus, placenta and membranes (AKA POC)
Imminent(AKA inevitable) INTERNAL CERVICAL OS DILATES; Bleeding and cramping increase. membranes may rupture
Incomplete INTERNAL CERVICAL OS DILATED SLIGHTLY; Some POC retained, most often placenta.
Complete All products of conception expelled
Missed abortion (FDIU) Fetus dies in utero, but not expelled. CERVIX CLOSED. Uterine growth ceases, may have brownish vag discharge. If fetus retained > 6 wks, breakdown of fetal tissue may result in release of thromboplastin and DIC may occur
Recurrent pregnancy loss (3 or >) AKA habitual abortion Abortion occurs consecutively in 3 or more pregnancies
Septic abortion (infection) Presence of infection; may occur in prolonged, unrecog ROM ; preg w/ IUD in place; unqualified abortionist
Abortions Assessment VS, amt/app bleeding, comfort, general health; if 12 wks or more, FHR, family coping,blood type, Rh
Abortions Nursing Diagnosis Fl Vol Def r/t exc bleeding sec to spon abort Acute pain r/t cramping sec to threatened abort Antic Grrieving r/t expected loss of unborn child
Abortions Evaluation able to explain spon ab/tx; no compl; she and part begin verbalizing grief/ackn process 6 – 24 mos
Most reliable indicators of potential spont. abortion... cramping and backache
_____ is done to determine the presence of cervical polyps or cervical erosion Speculum examination
hCG can confirm pregnancy, but when there is fetal death, hCG... falls
The therapy prescribed for preg woman w/ bleeding is.... bed rest, abstinence from coitus, emotional support
If bleeding persists and abortion is imminent (inevitable)... the woman may be hospitalized, IV for fluid replacement, and D&C or suction evacuation to remove POC. Rh neg/not sensitized = RhoGAM w/in 72 hrs
In missed abortion (fetal/embryo death) , POC often expel spontaneously; if not expelled in 4 - 6 wks and FIRST semester... hospitalized, D&C or suction evac
In missed abortion (fetal/embryo death) , POC often expel spontaneously; if not expelled in 4 - 6 wks and SECOND trimester... hospitalized, labor induced OR dilation and EVACUATION (D&E)
A majority of spontaneous abortions are r/t... chromosomal abnormalities
Other causes of spontaneous abortions are... teratogenis drugs, faulty implantation r/t reproductive tract abnormality, wek cervix, placental abnormalities, chronic maternal illness, endocrine imbalance, infection
Women who use hot tubs or Jacuzzis are... twice as likely to have miscarriage (hyperthermia of core temp)
Grieving from spontaneous abortion usually lasts... 6 - 24 months
After outpatient procedure for incomplete or missed abortion, nurse advises... pt. to report heavy or bright red bleeding, take full course of abx (antibiotics), delay pregnancy at least 2 months for healing
A majority of spontaneous abortions are r/t... chromosomal abnormalities
Other causes of spontaneous abortions are... teratogenis drugs, faulty implantation r/t reproductive tract abnormality, wek cervix, placental abnormalities, chronic maternal illness, endocrine imbalance, infection
Women who use hot tubs or Jacuzzis are... twice as likely to have miscarriage (hyperthermia of core temp)
Grieving from spontaneous abortion usually lasts... 6 - 24 months
After outpatient procedure for incomplete or missed abortion, nurse advises... pt. to report heavy or bright red bleeding, take full course of abx (antibiotics), delay pregnancy at least 2 months for healing
Created by: CCBCMDNursing218