2. Threatened Abortion
ï± Conservative with bed rest and reassurance till
bleeding stops.
ï± Sexual intercourse best avoided.
ï± Follow up with ULTRASOUND-presence of fetal
cardiac activity predicts good outcome in 95%of
cases.
ï± Hormone therapy -400mg natural progesterone
in 2divided doses orally or vaginally on
empirical basis.
ï± Anti D if mother is Rh negative and pregnancy is
beyond 12 weeks.
3. Inevitable Abortion
ï± Immediate evacuation of pregnancy.
(If duration of pregnancy less than 12 weeks-
suction evacuation and greater than 12 weeks
oxytocin infusion.)
ï± Shock-resuscitation with i/v fluids and blood
transfusion.
ï± Prophylactic antibodies and anti-D.
9. Incomplete Abortion
ïš Resuscitation if patient is in shock and
evacuation by suction evacuation.
ïš If the os is closed PGE1 tablets are kept in
vagina for ripening the cervix.
ïš Prophylactic antibodies and anti D
11. Missed Abortion
ïš Uterus evacuated as soon as possible. A
donor should be kept ready.
ïš If uterine size is less than 12 weeks of
gestation PGE1 tablets kept in vagina results
in spontaneous expulsion without the need of
surgical intervention.
ïš If more than 12 weeks, 6th or 12th hourly PGE1
tablets used vaginally results in spontaneous
expulsion or extra amniotic ethacridine
acetate.
ïš Anti D and antibiotics.
12. Septic Abortion
ïš Police notification if a criminal abortion is
suspected.
ïš Mild cases-broad spectrum antibiotics are
started and uterus evacuated.
ïš Severe cases-maintenance of perfusion and
ventilation.
ïš I/v infusion and CVP line is inserted
ïš Blood transfusion
ïš Oxygen given by nasal catheter.
14. Septic Abortion(contâŠâŠ..)
ïš Antibiotics commenced after taking a high
vaginal swab.
ïš Ampicillin,Gentamycin and Metronidazole/third
generation cephalosporin like cefotaxime or
cefuroxime with metronidazole or clindamycin.
ïš Evacuation of uterus after infection is
controlled.
