Abortion: diagnosis And medicine

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The determination of an abortion is determined in a pregnant woman who presents with vaginal bleeding or expulsion of Poc. However 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 minuscule spotting be carefully as abortion or threatened abortion and investigated appropriately.

A standard history must be elicited from the lady, enquiring in detail about the quantity of bleeding, any connected pain and other symptoms. This should be followed by a general bodily exam with emphasis on looking for pallor, tachycardia (Increased Heart rate), and Bp.

Thereafter a optical inspection of the genital areas is done to estimation the actual bleeding. A Pv exam 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 describe any abnormalities.

An Usg is the gold standard 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 unblemished blood count, urine analysis, and Hcg levels are also done.

Treatment

Threatened Abortion is typically treated conservatively. Accurate bed rest is normally advised for three to five days. Thereafter women are encouraged to move gradually. Any connected conditions like high Bp should be corrected. Laxatives and fluids are normally prescribed to preclude straining in the toilet.

Many gynecologists prefer to prescription progesterone to women with threatened abortion. However the author is of this view that this authentically does not help the pregnancy. Although there are determined anecdotal evidence that progesterone may prolong pregnancy, there is no clear evidence to this effect.

A unblemished abortion will normally wish no rehabilitation other than just ensuring that all products of thought have been expelled.

An incomplete and missed abortion will both wish healing intervention to expel the retained products of conception. This is comfortably done by surgical procedures like D&C or may be done by using drugs used in healing abortion like misoprostol.

Pregnancy After Abortion

An abortion will normally have no deleterious effects on supplementary fertility. After abortion, general periods should return by about 4-6 weeks time. In the meantime women may observation recurrent spotting or other bleeding intermittently, which is quite general and will not wish any exact management.

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