Please enable JavaScript.
Coggle requires JavaScript to display documents.
7b Miscarriage, Abortion and Termination of Pregnancy - Coggle Diagram
7b Miscarriage, Abortion and Termination of Pregnancy
Miscarriage: spontaneous termination of pregnancy before 20 weeks of gestations , aka spontaneous abortion 自然流产
Causes
Fetal causes
Abnormal conceptus (chromosomal - trisomy, structural - neural tube defect, genetic - X-linked disease)
Maternal causes
Immunological, e.g. autoimmune disease - (SLE) systemic lupus erythematosus 系统性红斑狼疮
Uterine abnormality, e.g. congenital septate uterus - recurrent abortion, cervical incompetence - second trimester abortion
Fibroids, 1. cause disruption of implantation & development of the fetal blood supply, 2. occupy of space for the fetus to grow
Infections (maternal/ fetal), e.g. TORCH infections
Environmental toxins, e.g. smoking, alcohol, drug abuse and radiation辐射
Endocrine, e.g. poor controlled diabetes, hypothyroidism 甲状腺功能减退 and hyperthyroidism 甲亢
Clinical manifestations
ameenorrhoea闭经, vaginal bleeding, lower abdominal cramping/ pain, positive pregnancy test (hCG), vaginal examination - cervix closed/ dilate
Risk Factors
maternal age (more than 35 y/o), increased gravidity (pregnant multiple time), previous history of miscarriage, multiple pregnancy, in-vitro fertilization, (PCOS) Polycystic ovarian syndrome 多囊卵巢综合征
diagnostic evaluations
- (FBC) Full blood count, 2. blood urea & serum electrolyte: ensure baseline, 3. blood grouping & cross-match: in case blood transfusion is needed, 4. urine FEME: check is it uterine infection, 5. urine pregnancy test (hCG), 6. ultrasound of abdomen
incidences 发病率: most common complication in pregnancy, higher maternal age
-
-
Nursing Intervention
Psychological care
Counselling referral, support group, provide adequate space and time for the couple to grief
Observation
-
Observe pad chart for the amount and characteristics of discharge - determine the amount of blood loss
Monitor for post-op complications such as hypovolemic shock, pelvic infection - provide early intervention
Complications
hemorrhage, infection, sepsis, death
(TOP) Termination of pregnancy: a procedure to terminate a pregnancy by using medical or surgical methods before 20 weeks of gestations , aka induced abortion 人工流产
Management
Medical (drugs)
e.g. MISOPROSTOL : opening of cervix, cause bleeding, expelling the pregnancy tissue
-
-
-
Surgical
VACUUM ASPIRATION/ SUCTION CURETTAGE吸刮术: suctioning out the content of uterus w/ manual/ power-operated device
-
Abortion: termination of pregnancy before 20 weeks of gestations, either spontaneous or induced 自然或人工