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LO 5 : 1st, 2nd adn 3rd

Trimester Bleeding
1st Trimester Bleeding
1. Abortion
is the expenditure of conception before the
fetus is able to be outsite the womb / weight below
500 grams.
• Etiology
• fetal factors
• mother factors
• external factors
• Pathophysiology
fetal death→ decidual basal hemorrhage→
necrosis of surrounding tissue → the resultt of
conception being released → a foreign body in the
uterus → the uterus contracting out its contents.
classification
A. Spontaneous Abortion
1. imminens abbortion : threatening abortion,
pregnancy can still be maintained.
Diagnosis : -bleeding a little
- there is no severe abdominal pain
- ostium uteri is closed
- the size of the uterus correponds to
the age of pregnancy
Therapy :
- out patient
- bed rest
2. Inspid Abortion
Abortion is on going and ends with complete /
incomplete abortion.
Diagnosis : - bleeding and contaction pain
- portion is open
- pregnancy is still in womb

Therapy : evacuation
3. Incomplete Abortion
Some pieces of pregnancy continue to come
out and there is still residue in uterine cavity.

Diagnosis: - bleeding a lot


- uterine contractions
- ostium is open, palpable tissue

Therapy :
- evacuation
- uterotonic
-antibiotics
4. Complete Abortion
All pieces of pregnancy have come out of the
uterine cavity.
Diagnosis : -perpaginal bleeding
-uterine contactions
-closed cervical ostium

Therapy :
Antibiotic
5. Missed Abortion
Restrained conception results that have died
more than 8 weeks in the womb.

Therapy :
-evacuation
-uterotonic
-antibiotics
B. Abortion Provocatus
is intentional abortion, whether using drugs or
devices.
• medicalinal abortion
• criminal abortion
2. ectopic pregnancy
is pregnancy with implantation occurs outside
the uteribee cavity such as the fallopian tubes,
ovarium.
Epidemiology : in one spontaneous conception
occurs in 30.000 / less
Etiology :
- contraceptivee use
-zigot abnormalities
-tubal factors
2nd and 3rd Bleeding
1. Plasenta Previa
is the placenta coverrs the ostiom or low
position.
classification : total, partial and marginal..
clinical :
- vaginal bleeding
-can cause abnormal fetal location
Therapy : - manual placenta
- hysterectomy
2. solutio plasenta
is release of the placenta from the premature
implantation site.

Classification :
- total : fetal death
- partial :the fetus can tolerate the release of 30-50%
of the placenta

Etiology : - abdominal trauma


-previous history of solutio
-excessive uterine streching