Abortion

Question 1

List all the types of abortion (cervix open or closed? Visible passage of products of conception or not? Complete or incomplete?)

Answer 1

1) Spontaneous Abortion:
Also known as miscarriage.
Occurs naturally without medical or surgical intervention.
Can be classified as complete or incomplete, depending on whether all fetal tissue is expelled or not.
The cervix may be open or closed, depending on the stage of miscarriage.

a. Threatened Abortion:
Definition: Refers to vaginal bleeding during early pregnancy (up to 20 weeks) without the cervix opening and without the passage of products of conception.
The pregnancy may still continue successfully, or it may progress to a miscarriage.

b. Missed Abortion (also known as Silent Miscarriage):
Definition: A nonviable pregnancy in which the embryo or fetus has stopped developing, but the products of conception are retained within the uterus.
There may be no symptoms or signs of miscarriage, and the woman may continue to have normal pregnancy symptoms.
The cervix is typically closed, and there may be no vaginal bleeding or only minimal spotting.

c. Complete Abortion:
Definition: The expulsion of all products of conception from the uterus.
This includes the embryo or fetus and the placenta.
The cervix is usually closed after the passage of all pregnancy tissue.
There may have been vaginal bleeding, cramping, and passage of recognizable products of conception.

d. Incomplete Abortion:
Definition: Incomplete passage of products of conception from the uterus.
Some pregnancy tissue remains in the uterus after the passage of some fetal or placental tissue.
The cervix is typically open, allowing for continued bleeding and the potential for infection.
Symptoms may include vaginal bleeding, abdominal pain, and the passage of tissue.

2) Induced Abortion:
A deliberate termination of pregnancy performed through medical or surgical means.
The specific method used may vary depending on gestational age and other factors.

a. Medical Abortion:
Uses medication to induce abortion.
Typically involves a combination of drugs, such as mifepristone and misoprostol.
Can be done in the early stages of pregnancy (up to around 10 weeks).

b. Surgical Abortion:
Involves a surgical procedure to remove the contents of the uterus.
The cervix may be dilated (opened) before the procedure.
The specific surgical methods include:

i) Manual Vacuum Aspiration (MVA):
Uses a manual suction device to remove the contents of the uterus.
Generally performed in the first trimester (up to around 12 weeks).

ii) Electric Vacuum Aspiration (EVA):
Similar to MVA but uses an electric suction device.
Commonly performed in the first trimester.

iii) Dilation and Curettage (D&C):
Involves dilation of the cervix and scraping or suctioning of the uterine lining.
Can be performed in the first and second trimesters.

iv) Dilation and Evacuation (D&E):
Similar to D&C but used for second-trimester abortions.
Involves dilation of the cervix and removal of fetal tissue using surgical instruments.