Today, we will get to know about one of the most discussed topics in midwifery incomplete abortion.
Before that, allow me to take you on a quick drive on Abortion.
In English, the word “abort” means to terminate, to cease development, or to stop something from reaching its end.
WHAT THEN IS ABORTION?
Abortion is a medical procedure done to terminate a pregnancy. It leads to the “expulsion” or removal of an embryo or fetus( baby).
DIFFERENT PERSPECTIVES ON ABORTION.
Based on culture, religion, and law; there are different views on abortion around the world. In some parts of the world, abortion is only legal in cases like rape, a risk to the mother's health, and fetal defect. There are a lot of controversies on abortion. However, abortion is still very common today.
According to World Health Organization (WHO), Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. WHO aims at making health a reality for all including quality abortion care services (the right information on abortion, proper management of abortion, and proper management after abortion).
According to WHO, more than half of all pregnancies every year are unintended. Statistics show that out of 10 pregnancies, 6 are unintended, and 3 out of the10 end in abortion.
Abortion is a simple and safe procedure when carried out according to the WHO recommendations, at the appropriate time of pregnancy, and by licensed healthcare personnel.
TYPES OF ABORTION
There are two types of abortion;
Induced Abortions are intended abortions which means, there is a reason for abortion. For example, in the United Kingdom, about 2% of abortions are due to genetic issues in the fetus. There are different methods for intentional abortions. It can be medically or surgically done and these methods depend on the gestational age
of the embryo or fetus. Gestation age is the age of pregnancy beginning from the woman's last menstrual period.
Spontaneous abortion is just the opposite of induced abortion. They are unintentional. It mostly occurs in the first trimester and is usually sudden. For easy understanding;
Pregnancy is divided into 3 trimesters.
| Trimester | Duration |
|---|---|
| 1st trimester | From the last Menstruation - 12 weeks |
| 2nd Trimester | 13 weeks - 26 weeks |
| 3rd Trimester | 27 weeks - 40 weeks |
Spontaneous abortion is mostly due to chromosomal abnormalities of the embryo or fetus (baby). A normal individual has 46 chromosomes of which 23 is from each parent. However, a situation where a chromosome is missing, switched, or turned upside down is referred to as chromosomal abnormality. Other than abnormalities in chromosomes; infection, uterine abnormalities (abnormalities of the uterus), and incompetent cervix (where the cervix opens too early in pregnancy) can lead to spontaneous abortion.
CLASSIFICATION OF ABORTION.
| Early Abortion | Occurs in the first trimester |
|---|---|
| Late Abortion | Occurs in the second trimester |
| Threatened Abortion | Here, vaginal bleeding occurs without dilation of the cervix. An indication of spontaneous abortion |
| Inevitable Abortion | Here, vaginal bleeding occurs with dilation of the cervix |
| Therapeutic Abortion | Occurs due to a threat to the mother's health |
| Complete Abortion | All the products of conception are expelled |
| Incomplete Abortion | All the products of conception are not completely expelled |
Incomplete Abortion occurs when pregnancy tissues remain in the womb. Recently, the incidence of incomplete abortion has risen due to poor medical services, self-medication, or drug abuse. I remember during my midwifery posting, we had a case of incomplete abortion, the woman complained that she visited a clinic and was given pills which she took, and even after 2 months, she was still bleeding. There are some signs and symptoms
peculiar to incomplete abortion.
SIGNS AND SYMPTOMS OF INCOMPLETE ABORTIONS.
Incomplete Abortion can be treated using Manual Vacuum Aspiration. This is a minor surgical procedure used to treat incomplete abortion in the first trimester of pregnancy. It is carried out by licensed medical personnel and the procedure last for about 10-20 minutes after which pain medications are administered.
Studies have shown that incomplete abortion is more common in medical abortion (use of pills) and one of the major risks associated with incomplete abortion is sepsis (infection of the blood) hence the need for prompt treatment!
I hope this was beneficial to you.
Thank you.
References and further studies
UCSF Health
Cleburne Pregnancy Center
WebMD
Medicins Sans Frontieres.
wikipedia
