Abortion

NURSING

1. WELCOME PRESENTER NAME; MISS.LAXMI RAWAT 4 th YEAR BSC NSG(MCN) EVALUATOR NAME; MRS. SNEHLATA PARASHAR LECTURER

2. INTRODUCTION :- Abortion is also k/a miscarriage Abortion is the ending of pregnancy By removing a fetus or embryo Before it can survive outside the Uterus ,if the fetus or wt is less than 500gm at 20 weeks of gestation. The expelled embryo or fetus is called abortion . It may be induced or spontaneous .

3. DEFINITION ACCORDING TO K . NILAM ; Abortion is termination of pregnancy by any means before the fetus is sufficient to developed to survive ACCORDING TO NINA BHASKAR ; An abortion is the premature expulsion of products of conception from uterus it can be either spontaneous or induced .

4. INCIDENCE :- The number of abortion performed world wide with 41.6 million in 2003 43.8 million in 2009

5. In india about 6 million abortion are take place , 2 million abortion are spontaneous and 4 million Induced . 38,000 death from unsafe abortion unusually World wide ……..

6. CAUSES OF ABORTION:- MATERNAL CAUSES; 1.Maternal infection 2.Maternal disease 3.Drugs 4.Hormonal disturbance FETAL CAUSES; Chromosomal anomalies Blighted ovum Hydatidiform moles Congenital defect

7. OTHER CAUSES:- Uterine developmental anomalies Retroversion Fibromyoma of uterus Surgery during pregnancy. Environmental factors- cigarette,alcohol Immune factors- Rh- ve blood

8. THREATENED ABORTION:- It is a clinical entity where choriodecidual Hemorrhage has begun , but not progressed To the stage of irreversibility , this means the Cervix is not open and the product of concept- -ion ,are not expelled . Baby survival is possible C/M :-painless vaginal bleeding without uterine contraction,cervix is soft. D/A :- blood,urine,usg ,thyroid FT. T/T :- HRT,HCG inj .,Analgesic….

9. INEVITABLE ABORTION:- In this type of abortion the process has begun $ progressed to such an extent that expulsion Of the product of conception seems inevitable . Continuation of pregnancy is impossible . C/M:- vaginal bleeding with clot or product of Conception . D/A:- H/C, vaginal exam. , blood,USG , T/T:-less than 12 weeks –suction evacuation more than 12 weeks –oxytocin 10unit 500ml NS

10. MISSED ABORTION

11. SEPTIC ABORTION

12. PATHOLOGY:- In the majority 80%,the organism are of endogenous Origin and the infection is localized to the conceptus Without any myometrium involment . in about 15% , the infection either produces localized endomyometritis Surrounded by a protective leukocytic barrier or spread To the parametrium tubes ovaries or pelvic peritoneum . In about 5% , there is generalized peritonitis and endotoxic shock .

13. NURSING MANAGEMENT:- Preoperarive care:-- Postoperative care :-- Health education :- DIET :-fresh fruits pulses , cereals , wholes Avoid smoking ,refined food . EXERCISE :- Avoid heavy work and heavy exercise HYGIENE :- maintain perineal hygiene .

14. MEDICAL TERMINATION OF PREGNANCY ACT ( 1971):- MTP is a medical termination of pregnancy . Its also known as induced abortion .It is the medical way to getting rid of Unwanted pregnancy . The termination of a pregnancy by the removel or exoulsion of an embryo or fetus from the uterus ..

15. QUALIFICATION FOR MTP; Assist 25 cases of mtp in approved institution 6 month housemanship in OBG. PG qualification in OBG. 3yrs practices in OBG .

16. PLACE FOR MTP; Place established and maintain ed by govt. Non govt. institution can perfo rm , they obtain licence from CMO Of distict

17. INDICATION FOR MTP:- Risk of injury to mental $ physical health of Woman Abnormalties in fetus . Pregnancy caused by rape . Contraceptive failure .

18. METHOD OF TERMINATION :- 1 st trimester :- MEDICAL – Mifepristone + Misoprostol methotrexate +misoprostol tamoxifam + mosoprostol SURGICAL – vaccum aspiration suction evacuation dilatation and curettage

19. 2 nd trimester – MEDICAL – misoprostol, carboprost SUGICAL – and curettage , D/C Hystrectomy Hysterectomy .

20. COMPLICATION :- Injury to the cervix Uterine perforation Hemorrhage and shock Menstrual disturbance Chronic pelvic inflammation etc.