WHAT IS AN INEVITABLE ABORTION ?

1. Inevitable abortion means the process of expulsion of products of conception has become irreversible. The expulsion of products of conception has not occurred but it is bound to happen and nothing can be done to stop this process. WHAT ARE THE CLINICAL FEATURES OF INEVITABLE ABORTION ? Inevitable abortion is usually preceded by threatened abortion.Following are the clinical features of inevitable abortion: 1. AMENORRHOEA, there is history of amenorrhoea, usually of 2-3 months. Other symptoms of early pregnancy are also present in most of the patients. a)Morning sickness. b)Breast enlargement and discomfort. c)Frequency of micturition. 2.Bleeding per vagina, The bleeding per vagina in the beginning is bright red and scanty in amount, later the loss becomes heavy, with passage of clots.In case of severe bleeding,the blood loss may exsanguate the patient and result in hemorrhagic shock. Sometimes when the blood is retained in the vagina in the form of clots, the vagina becomes ballooned up. 3.Pain:Pain is a characteristic feature of inevitable abortion. It is characterized by lower abdominal cramps(due to painful uterine contractions). The intensity of pain depends upon the duration of pregnancy and parity of the patient. In a late second trimester abortion, this pain may simulate labour pains. But in a case of early abortion the patient may either complain of continuous and severe lower abdominal pain,or there may be only a dull ache. 4.Size of the uterus:In an inevitable abortion,as all the products of conception are still in the uterine cavity, the size of the uterus corresponds to the duration of the gestation. 5.Dilatation of Cervix :This is a pathogenic sign of inevitable abortion. Once the internal Os of the Cervix starts dilating, it means that the abortion is inevitable The sac of membranes or the foetus may be felt through the dilated cervix.

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