Question | Answer |
When does spontaneous abortion occur? | In 1st trimester, before 20 weeks. |
What are EARLY (1st Trimester) causes of Spontaneous Abortion? | Genetic/Chromosomal Abnormalities |
What are LATE (2nd Trimester) causes of Spontaneous Abortion? | Maternal Causes R/T Conditions or Drugs
Premature (Insufficient) Dilation of Cervix
Uterine or Cervical Defects (Fibroid)
Chronic Conditions (DM, Hypothyroidism, Nephritis, HTN)
Blood Disorders (Thrombophilias)
Lupus
Infections & Crack Cocaine |
What is a THREATENED Abortion? | A DEVELOPING spontaneous Abortion |
What are S/S of THREATENED abortion? | SLIGHT vaginal bleeding early in pregnancy
NO dilation of cervix (closed)
MILD uterine cramping
No Conception Tissue Exposed |
What DX test will be done for THREATENED abortion? | Ultrasound to SEE IF SAC IS EMPTY
Decreased hCG levels
Decreased Progesterone Levels |
How do you TX THREATENED abortion? | Conservative support
Bed Rest
Nutritious Diet
Hydration |
What is an INEVITABLE abortion? | When the passage of products of conception WILL occur. |
What are the S/S of INEVITABLE abortion? | MODERATE to HEAVYBleeding
Cervical DILATION
STRONG uterine cramping
RUPTURE of MEMBRANES
TISSUE is EXPELLED |
What DX test will be done for INEVITABLE abortion? | Ultrasound to SEE IF PREGNANCY IS LOST
Decreased hCG levels |
How do you TX INEVITABLE abortion? | VACUUM CURETTAGE to retrieve tissue/Prevent Hemorrrhage and Infection
Give prostaglandin analog (MISOPROSTOL) |
What is an INCOMPLETE abortion? | The EXPULSION of FETUS w/ RETENTION of PLACENTA |
What are S/S of INCOMPLETE abortion? | HEAVY Bleeding
Cervical DILATION
INTENSE uterine cramping
TISSUE is EXPELLED |
What DX test will be done for INCOMPLETE abortion? | Ultra Sound to SEE THAT PLACENTA IS STILL IN UTERUS |
How do you TX INCOMPLETE abortion? | STABILIZE the CLIENT
D&C to RETRIEVE PLACENTA
Prostaglandin (MISOPROSTOL) |
What is a COMPLETE abortion? | ALL fetal tissue (BABY & PLACENTA) is EXPELLED |
What are S/S of COMPLETE abortion? | HX of VAGINAL BLEEDING & ABDOMINAL PAIN
TISSUE is EXPELLED
VERY LITTLE CURRENT BLEEDING
VERY LITTLE CURRENT PAIN
S/S of pregnancy DISAPPEAR |
What DX test will be done for COMPLETE abortion? | Ultrasound SHOWS EMPTY UTERUS |
How do you TX COMPLETE abortion? | NO TX, Only FOLLOW UP for Family Planning |
What is a MISSED (Mother is Unaware) abortion? | When the NONVIABLE embryo is in uterus for at least 6 weeks |
What are S/S of MISSED abortion? | IRREGULAR SPOTTING
ABSENT uterine CONTRACTIONS
MAY PROGRESS TO INEVITABLE abortion
S/S of pregnancy DISAPPEAR
Possible INFECTION |
What DX tests will be done for MISSED abortion? | Ultrasound AFTER DECREASE or NO INCREASE of Fundal Height |
How do you TX MISSED abortion based on gestation? | 1st Trimester -D&C
2nd Trimester- INDUCED LABOR & PGE2 to empty uterus w/o surgery |
What is HABITUAL abortion? | HX of 3 or more CONSECUTIVE spontaneous abortions.
Pt. is not able to carry pregnancies to term. |
What DX tests will be done for HABITUAL abortion? | Assess Client HX. |
How do you TX HABITUAL abortion? | Determine Cause (Genetic/Reproductive Abnormalities, Insufficent Progesterone, Infection, Diseases)
CERVICAL CERCLAGE in 2nd Trimester is cause is INCOMPLETE CERVIX |
What will you ASSESS for all abortion? | Uterine Bleeding for color amount and characteristics
Count pads and saved clots
Intensity, type and duration of pain/cramping
Persistent Lower back pain
LMP, V/S
Previous pregnancy losses
Pt Knowledge of situation
Pt. Emotional state |