Conditions associated with first

tri bleeding
Spontaneous abortion
 Spontaneous abortion
• Unintended termination of pregnancy at any
time before the fetus has attained viability
• Faulty ovum fxn, chromosomal abnormalities,
abnormal placental fxn
AGE OF VIABILITY: 20 WKS
Viable fetus – fetus more than 20 – 24 wks of
gestation or one that weighs @ least 500g
 Manifestations
• Uterine cramping – labor like symptoms
• Lower back pain
• Vaginal bleeding
 Types
1. Threatened abortion
• Slight vaginal bleeding
• Closed cervical os
• Mild abdominal cramping
• Can save a baby through bed rest and med

2. Inevitable abortion
• Vaginal bleeding
• ROM
• Cervical dilation
• Strong abdominal cramping
 Types

3. Incomplete abortion
• Passage of some products of conception
• Intense abdominal cramping
• Heavy vaginal bleeding

4. Complete
• Passage of products of conception
• ↓ in pain and vaginal bleeding after passage
 Types

5. Missed abortion
• Nonviable embryo retained in utero for @ least 6 weeks
• Absent uterine contractions
• Irregular spotting
• Fetus still inside the uterus

6. Habitual abortion
• Hx of 3 or more consecutive spontaneous abortions
• Not carrying pregnancy to term
 Complications
• Hemorrhage – inc abortion – uterus can’t
contract effectively
• Infection – cevix open – microorganism have
free access to the uterus
• Septic abortion – infection
• Isoimmunization – Rh incompatibility
• Powerlessness or anxiety
 Med mngt
• Inc and missed abortion
• D&C
 Common drugs used with
spontaneous miscarriage
1. misoprostol (cytotec)
• Stimulates uterine contraction
• Evacuate the uterus after abortion to ensure passage of all products
of conception

2. Dinoprostone
• Stimulates uterine contraction
• Expel uterine contents in fetal death, missed abortion

3. Rh (D) immunoglobulin – Rhogam

• Suppresses immune response of nonsensitized Rh- patients
• Prevents isoimmunization