1
Q
Abortion
A
Termination of a pregnancy before viability
2
Q
Induced Abortion
A
Medical termination
3
Q
Elective Abortion
A
Women’s request
4
Q
Therapeutic Abortion
A
- Elective and induced
- Maternal medical condition
- fetal anomalies
5
Q
Spontaneous Abortion
A
“miscarriage”
- Causes: Chromosomal abnormalities, teratogens, faulty implantation, female trauma, maternal illness, weak cervix
- Tx: depends on what type
- Fetal death may not precede the abortion
6
Q
Risk factors for Abortions
A
-age = most significant
-increased parity
-endocrine abnormalities
-drug use
infection
-uterine/cervical abnormalities
-fetal genetic aborms.
7
Q
Threatened Abortion
A
- days of unexplained bleeding/ mild cramping
- cervix remains closed
- risk of expulsion
- Tx: Limit activity, avoid stress, fatigue, sex, be honest (explain conditions, may lose baby)
8
Q
Imminent Abortion
A
- Termination in progress (bleed, cramp, cervix dilates, ROM)
- Placenta detaches and begin to bleed.
- Tx: monitor bleeding (may need d/c. US to make sure everything is out
9
Q
Incomplete Abortion
A
- Conception products partially retained
- S/S: bleeding (heavy), fragments
- Tx: D/c to remove remaining contents, pitocin to cause contractions, methergrine for contractions and expel uterine contents
10
Q
Complete Abortion
A
- All products of conception expelled
- S/S: menses, heavy flow
- Tx: not required
11
Q
Missed Abortion
A
- fetus dies in utero but is not expelled
- breast swelling and fullness, uterus stops growing, cervix remains closed and no products expelled, may have brownish spotting.
- fetal autolysis can occur if fetus remains in utero after death. No longer alive or receiving nutrients
12
Q
Recurrent Pregnancy Loss
A
- Consecutive abortions (2 or more)
- Causes: Anatomic (incompetent cervix. cervix is weak and results in opening prematurely and loss of concep. prods.) Hormonal (uterine fibroids, abnormal shape, hormonal imbalance) Other ( immune system probs
- Tx: depend on cause.
13
Q
Septic Abortion
A
- presence of infection
- ROM: membranes are ruptured for a prolonged period and it is not diagnosed.
- IUD: pregnancy implanted in uterus with IUD increases risk of ascending infection
- Tx: remove prods of conception and tx infection
14
Q
Blighted Ovum
A
- Ovum development stops in first trimester
- absence of properly developed and recognizable fetal parts
- No FHR or gest. sac
15
Q
Nursing Care
A
- Monitor for bleeding, VS (^HR and BP), labs, pain.
- RhoGam if Rh neg.
- teach about when to call MD, no sex, tamps, or douching for 6 weeks (pelvic rest)
- emotional support
16
Q
Medical interruption: 1st trimester
A
- RU 486 (mifepristone) with misopristol causes uterine contraction. Mif pill first, the miso days later. leads to abortion.
- Methotrexate: chemotherapeutic, off labeled use up to 7 weeks
- Misopristol (cytotec)- oral, rectal, vaginal
17
Q
2nd trimester interruption
A
- D+E - passed 12 weeks
- suction instruments bc fetus is too big. later in preg.
- mif. with mis. have mom labor and deliver
18
Q
1 risk of elective abortion
A
Hemorrhage
-infection. trauama. retained products
Nursing 201
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