Definition:
-
Abortion is defined as termination of pregnancy either
spontaneously or intentionally before 20 weeks based upon the date of the first
day of the last normal period.
-
One more definition is delivery of a fetus – neonate
that weighs less than 500gms.
-
Definitions can vary according to state laws.
Usually more than 80% of abortions occur in the first 12
weeks.
In them chromosomal anomalies are responsible for at least
half of the cases.
Causes :
- Defective implantation.
-Defective development of the embryo.
-Nonembryonic pregnancy or blighted ovum.
Above two can occur due to defective sperm or defective ovum or both.
- Maternal infections like rubella, chlamydia etc.
- Deficiency of progesterone or human chorionic gonadotropin etc.
- Traumatic causes like fall etc.
Risk factors:
- Defective implantation.
-Defective development of the embryo.
-Nonembryonic pregnancy or blighted ovum.
Above two can occur due to defective sperm or defective ovum or both.
- Maternal infections like rubella, chlamydia etc.
- Deficiency of progesterone or human chorionic gonadotropin etc.
- Traumatic causes like fall etc.
Risk factors:
-
The risk of spontaneous abortion increases with parity,
maternal and paternal age.
-
The risk of clinically recognized abortion is 12% in
women with age less than 20 years, whereas the risk increases to 26% in women
with age more than 40 years.
-
The incidence increases if a women conceives within
three months of a term birth.
The impact of abortion on future pregnancies and possible
complications:
-
Usually fertility is not altered by an abortion.
-
There is some possibility for pelvic infection.
-
Multiple sharp curettage abortion procedures may result
in increased risk of placenta previa.
-
But usually vaccum aspiration may not lead to future
complications.
-
Septic abortion:
Ø
It is a serious complication most often
associated with criminal abortion.
Ø
Usually severe hemorrhage, sepsis, bacterial
shock and acute renal failure etc features can be seen.
Ø
These can develop in legal abortions also but
with very less frequency.
Ø
Metritis can be seen. Sometimes parametritis,
peritonitis, endocarditis, septicemia etc can also occur.
Ø
Usually two thirds of the septic abortions occur
due to anaerobic bacteria.
Ø
Coliforms, haemophilus influenzae, campylobacter
jejuni, Group-A streptococcus etc are other organisms.
Treatment:
Ø
Broad spectrum antimicrobials intravenously.
Ø
If sepsis and shock supervenes supportive care
is needed.
Ø
Disseminated intravascular coagulopathy can occur sometimes.
Ovulation resumption after abortion:
- Sometimes ovulation
can resume as early as 2 weeks after an abortion.
- So effective
contraception should be initiated soon after abortion.
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(The viewers are invited to post comments or ask questions related to the topic through comment box.)
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