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The pathology of an abortion is definite in a pregnant woman who presents with vaginal bleeding or expulsion of Poc. Any way it come to be difficult when there is scant bleeding or no bleeding which can happen in incomplete abortion. Hence it is the author's view that any bleeding more than just diminutive spotting be carefully as abortion or threatened abortion and investigated appropriately.
A suitable history must be elicited from the lady, enquiring in information about the quantity of bleeding, any associated pain and other symptoms. This should be followed by a general corporal test with emphasis on looking for pallor, tachycardia (Increased Heart rate), and Bp.
Thereafter a visual inspection of the genital areas is done to assessment the actual bleeding. A Pv test is contraindicated and should not be done under any circumstance. A gentle palpation of the uterus straight through the abdomen may be done but is unlikely to characterize any abnormalities.
An Usg is the gold suitable diagnostic test for abortion. A ultrasound is mandatory in cases of suspected or confirmed cases of abortion. A Usg will not only confirm the diagnosis, it will also point out any complications like retained products, infection, etc.
Apart from these routine lab investigations like faultless blood count, urine analysis, and Hcg levels are also done.
Treatment
Threatened Abortion is typically treated conservatively. Exact bed rest is regularly advised for three to five days. Thereafter women are encouraged to move gradually. Any associated conditions like high Bp should be corrected. Laxatives and fluids are regularly prescribed to prevent straining in the toilet.
Many gynecologists prefer to prescribe progesterone to women with threatened abortion. Any way the author is of this view that this as a matter of fact does not help the pregnancy. Although there are definite anecdotal evidence that progesterone may prolong pregnancy, there is no clear evidence to this effect.
A faultless abortion will regularly want no rehabilitation other than just ensuring that all products of conception have been expelled.
An incomplete and missed abortion will both want curative intervention to expel the retained products of conception. This is conveniently done by surgical procedures like D&C or may be done by using drugs used in curative abortion like misoprostol.
Pregnancy After Abortion
An abortion will regularly have no deleterious effects on further fertility. After abortion, general periods should return by about 4-6 weeks time. In the meantime women may notice recurrent spotting or other bleeding intermittently, which is quite general and will not want any specific management.
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