SPONTANEOUS ABORTION

DEMECILLO, NOELLE S.
GYNECOLOGY DEPARTMENT

MS. DAFHNE C. GALLENDO

SIGNATURE

LEVEL II CCMC-CN 1
NAME: _DEMECILLO, NOELLE S.___ YEAR & SECTION: LEVEL II - B_________
SUBJECT/AREA: GYNECOLOGY DEPARTMENT WEEK & DATE: 02/13/2023______________

SPONTANEOUS ABORTION

Abortion is the medical term for any interruption of a pregnancy before a fetus is viable (able
to survive outside the uterus if born at that time). A viable fetus is usually defined as a fetus of more
than 20 to 24 weeks of gestation or one that weighs at least 500 g. A fetus born before this point is
considered a miscarriage or premature or immature birth. Elective abortion is the planned medical
termination of a pregnancy. When the interruption occurs spontaneously, it is clearer to refer to it as a
miscarriage.
Spontaneous miscarriage occurs in 15% to 30% of all pregnancies and arises from natural
causes . A spontaneous miscarriage is an early miscarriage if it occurs before week 16 of pregnancy
and a late miscarriage if it occurs between weeks 16 and 24.

● Threatened abortion – is characterized by cramping and vaginal bleeding in early pregnancy

with no cervical dilation. It may subside or an incomplete abortion may follow.
● Imminent or inevitable abortion – is characterized by bleeding, cramping and cervical
dilation. Termination cannot be prevented.
● Incomplete abortion – is characterized by expulsion of only part of the products of conception
(usually the fetus). Bleeding occurs with cervical dilation.
● Complete abortion – is characterized by complete expulsion of all products of conception.
● Missed abortion – is characterized by early fetal intrauterine death without expulsion of the
products of conception. The cervix is closed, and the client may report dark brown vaginal
discharge. Pregnancy test findings are negative.
● Recurrent (habitual) abortion – is spontaneous abortion of three or more consecutive
pregnancies. Recurrent pregnancy loss occurs in about 1% of women who want to be
pregnant.

Causes of Spontaneous Miscarriage

Spontaneous abortion may result from unidentified natural causes or from fetal, placental or
maternal factors.
1. Fetal Factors
● Defective embryologic development
● Faulty ovum implantation
● Rejection of the ovum by the endometrium
● Chromosomal abnormalities
2. Placental Factors
● Premature separation of the normally implanted placenta
● Abnormal placental implantation
● Abnormal placental function

LEVEL II CCMC-CN 2
3. Maternal Factors
● Infection
● Severe malnutrition
● Reproductive system abnormalities (eg, incompetent cervix)
● Endocrine problems(eg, thyroid dysfunction)
● Trauma
● Drug ingestion

Complications of Miscarriage
As with full-term childbirth, hemorrhage and infection are two of the most likely complications after
miscarriage. The risk for Rh isoimmunization and a woman’s psychological state also need to be
considered.

Assessment
Subjective:
● Crying
● Depression
● Expressed no support system
Objective:
● Weight loss
● Social isolation
Diagnosis
Risk for loneliness - Susceptible to experiencing discomfort associated with a desire or need for more
contact with others, which may compromise health.

Planning
After 1 week of nursing intervention, the patient will be able to discuss concerns and feelings and also
engage in social activities.

Intervention
Independent
● Establish a nurse-client relationship. The client may feel free to talk about feelings in the
context of an empathetic relationship.
● Accept client’s expressions of loneliness as a primary condition and not necessarily as a
symptom of some underlying condition. Provides a beginning point, which will allow the
client to look at what loneliness means in life without having to search for deeper
meaning.
● Support expression of negative perceptions of others and note whether the client agrees. This
provides opportunity for the client to clarify reality of the situation and recognize his or
her own denial.

LEVEL II CCMC-CN 3
 ● Encourage attendance at support group activities to meet individual needs (e.g., therapy,
separation/grief, religious). Can meet individual needs and help client begin to deal with
feelings of loneliness.
● Help the client establish a plan for progressive involvement, beginning with a simple activity
(e.g., call an old friend, speak to a neighbor). To help reduce feeling of loneliness

● Provide opportunities for interactions in a supportive environment (e.g., have client

accompanied, as in a “buddy system”) during initial attempts to socialize. This helps to
reduce stress, provides positive reinforcement, and facilitates a successful outcome.
Collaborative
● Refer to appropriate counselors for help with relationships or other identified needs. To help
the patient receive specified care.

Evaluation
After 1 week of nursing intervention, the client was able to socialize and expressed her concerns and
feelings.

REFERENCES:

Books
Pillitteri, A. (2009). Maternal & Child Health Nursing: Care of the Childbearing & Childrearing
Family, 6th edition. Lippincott Williams & Wilkins.

Internet source

Rnpedia. (2018, September 11). Spontaneous abortion nursing management. RNpedia. Retrieved
from https://www.rnpedia.com/nursing-notes/maternal-and-child-nursing-notes/spontaneous-abortion/

LEVEL II CCMC-CN 4