2-05. ABORTION

The termination of a pregnancy before the fetus is capable of living, thriving, and growing (viable) is the definition of abortion.

Loss of the fetus up to the 24th week of gestation is medically termed abortion, more commonly called miscarriage. Delivery of the fetus after the 24th week but before the full-term of the pregnancy is called premature birth. An abortion can occur spontaneously or be induced. Look at these types of spontaneous abortion.

a. Threatened Abortion.

(1) Signs and symptoms. Included are the following:

(a) Slight bleeding during pregnancy.

(b) Pain resembling menstrual cramps.

(c) Sometimes softening and dilation of the cervix.

(2) Treatment. The primary treatment is bed rest. If the patient continues to experience these signs and symptoms, the pregnancy may progress to complete abortion.

b. Inevitable Abortion. An inevitable abortion is a spontaneous abortion that cannot be prevented. The most common cause is an abnormally developed embryo or fetus. Other causes are physical trauma or emotional shock to the pregnant female.

(1) Signs and symptoms. Included are the following:

(a) Vaginal bleeding.

(b) Sometimes massive uterine contractions and cervical dilation.

(2) Treatment. Treat as follows:

(a) Start an IV with normal saline or Ringer’s lactate solution.

(b) Give fluids as rapidly as necessary to maintain the patient’s blood pressure while she is being transported to a medical treatment facility.

c. Incomplete Abortion. In this case, some of the products of pregnancy are expelled while other parts are retained.

(1) Signs and symptoms. Included are the following:

(a) Hemorrhage (bleeding, especially profuse).

(b) Persisting cervical dilation.

(2) Treatment. Treat as follows:

(a) Treat for shock, if necessary.

(b) Transport the patient to a medical treatment facility. A physician will remove any partially protruding products of a pregnancy.

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