abortion

ABORTIONABORTION

DEFINITION OF DEFINITION OF ABORTIONABORTION

Termination of pregnancy by any Termination of pregnancy by any means before the fetus is sufficiently means before the fetus is sufficiently developed to survivedeveloped to survive

Termination of pregnancy before 20 Termination of pregnancy before 20 weeks gestation based upon the date weeks gestation based upon the date of the first day of the last normal of the first day of the last normal menses (LMP).menses (LMP).

The delivery of a fetus-neonate that The delivery of a fetus-neonate that weights less than 500 g.weights less than 500 g.

TYPES OF ABORTIONTYPES OF ABORTION Spontaneous AbortionSpontaneous Abortion

CompleteComplete IncompleteIncomplete

Induced Abortion (Illegal in the Phil.)Induced Abortion (Illegal in the Phil.) Therapeutic AbortionTherapeutic Abortion Elective (Voluntary) AbortionElective (Voluntary) Abortion

Recurrent or Habitual AbortionRecurrent or Habitual Abortion Missed AbortionMissed Abortion

Threatened AbortionThreatened Abortion

Inevitable AbortionInevitable Abortion

Incomplete AbortionIncomplete Abortion

Missed AbortionMissed Abortion

CAUSES OF CAUSES OF SPONTANEOUS SPONTANEOUS

ABORTIONABORTION Fetal Factors – Abnormal Fetal Factors – Abnormal

development of:development of: ZygoteZygote EmbryoEmbryo Early FetusEarly Fetus PlacentaPlacenta

DEVELOPMENTAL STAGESDEVELOPMENTAL STAGES

Stage 1 – Fertilization Stage 1 – Fertilization Zygote Zygote


Stage 2 – (Days 2-3) 2 cell Stage 2 – (Days 2-3) 2 cell morulamorula


Stage 3 – (Day 4 – 5) Free BlastocystStage 3 – (Day 4 – 5) Free Blastocyst


Stage 4 – (Days 5-6) Implantation of BlastocystStage 4 – (Days 5-6) Implantation of Blastocyst

Phases of DevelopmentPhases of Development

OvulationOvulation Fertilization of ovum (Zygote)Fertilization of ovum (Zygote) Formation of free blastocyst -1Formation of free blastocyst -1stst wk wk Implantation of the blastocyst – end of Implantation of the blastocyst – end of

11stst wk wk Embryo – 3Embryo – 3rdrd wk after fertilization wk after fertilization Fetus – 8 wks after fertilization or 10 wks Fetus – 8 wks after fertilization or 10 wks

after onset of the last menstrual period. after onset of the last menstrual period.


ABORTIONABORTION Maternal Factors:Maternal Factors:

InfectionInfection HypothyroidismHypothyroidism Diabetes Mellitus (Uncontrolled)Diabetes Mellitus (Uncontrolled) Progesterone DeficiencyProgesterone Deficiency Severe MalnutritionSevere Malnutrition Smoking – 2X greater risk who Smoking – 2X greater risk who

smoke >14 cigarettes/daysmoke >14 cigarettes/day


ABORTIONABORTION Alcohol – 2X greater in women who Alcohol – 2X greater in women who

drink 2X a week, 3X greater in drink 2X a week, 3X greater in women who drink daily.women who drink daily.

Caffeine - > 4 cups per dayCaffeine - > 4 cups per day Radiation – minimum lethal dose on Radiation – minimum lethal dose on

the day of implantation is about 5 the day of implantation is about 5 radsrads


ABORTIONABORTION Environmental Toxins:Environmental Toxins:

Anesthetic gasesAnesthetic gases ArsenicArsenic LeadLead FormaldehydeFormaldehyde BenzeneBenzene Ethylene oxideEthylene oxide

Autoimmune Diseases – Autoimmune Diseases – antiphospholipid antibodiesantiphospholipid antibodies


ABORTIONABORTION Physical Trauma – Most Physical Trauma – Most

spontaneous abortions occur spontaneous abortions occur some time after death of the some time after death of the embryo or fetus. If abortion were embryo or fetus. If abortion were caused by trauma, it would not be caused by trauma, it would not be a recent accident but an event a recent accident but an event that had occurred some weeks that had occurred some weeks before the trauma.before the trauma.


ABORTIONABORTION Uterine Defects:Uterine Defects:

Acquired:Acquired: MyomasMyomas Intrauterine adhesionsIntrauterine adhesions

Developmental uterine defects eg. Developmental uterine defects eg. Unicornuate uterusUnicornuate uterus

Incompetent CervixIncompetent Cervix

Therapeutic AbortionTherapeutic Abortion Definition – The termination of Definition – The termination of

pregnancy before the time of pregnancy before the time of fetal viability for the purpose of fetal viability for the purpose of safeguarding the health of the safeguarding the health of the mother or if pregnancy was likely mother or if pregnancy was likely to result in the birth of an infant to result in the birth of an infant with grave malformations.with grave malformations.

The American College of The American College of Obstetricians & Obstetricians & GynecologistsGynecologists

Guidelines for Therapeutic Guidelines for Therapeutic AbortionAbortion1.1. When continuation of pregnancy may When continuation of pregnancy may

threaten the life of the woman or threaten the life of the woman or seriously impair her health.seriously impair her health.

2.2. When pregnancy has resulted from When pregnancy has resulted from rape or incestrape or incest

3.3. When continuation of pregnancy is When continuation of pregnancy is likely to result in the birth of a child likely to result in the birth of a child with severe physical deformities or with severe physical deformities or mental retardation.mental retardation.

Elective AbortionElective Abortion

Definition – the interruption of Definition – the interruption of pregnancy before viability at the pregnancy before viability at the request of the woman but not for request of the woman but not for reasons of impaired maternal reasons of impaired maternal health or fetal disease.health or fetal disease.

Septic AbortionSeptic Abortion

Abortion accompanied by Abortion accompanied by infection.infection.

Usually caused by criminal or Usually caused by criminal or illegal abortion (an abortion illegal abortion (an abortion performed by someone not performed by someone not qualified to do the procedure)qualified to do the procedure)

Symptoms of AbortionSymptoms of Abortion Vaginal bleedingVaginal bleeding Abdominal pain maybe Abdominal pain maybe

accompanied by low back pain. accompanied by low back pain.

If you are pregnant & If you are pregnant & have these symptoms have these symptoms – immediately seek – immediately seek

consultation with your consultation with your Obstetrician!Obstetrician!

THANK YOU!THANK YOU!

&&

GOOD DAY!GOOD DAY!

abortion

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