Is the termination of a pregnancy by the

removal or expulsion from the uterus of a fetus or embryo, resulting in or caused by its death.

most miscarriages are due to incorrect replication of chromosomes.  Do NOT give false reassurance regarding future childbearing  Instruct on perineal care.  Administer pain medications as needed and as prescribed . and encourage to do perineal care following each urination. they can also be caused by environmental factors.Types  Spontaneous abortion (also known as miscarriage) is the expulsion of an embryo or fetus due to accidental trauma or natural causes before approximately the 22nd week of gestation.  INTERVENTION  Maintaining adequate fluid volume  Establish and maintain an IV with large intracath.

Voluntary Abortion is a termination of a pregnancy before fetal viability as a choice of the woman.  Intervention  Providing Psychosocial Support  Encourage woman to explore all options available regarding the pregnancy  Preventing Infection  Instruct on sign of infection and instruct to report these to physician if they develop following discharge. . Therapeutic Abortion is the termination of pregnancy before fetal viability for the purpose of safeguarding the woman s health.

Uterine Prolapse  Herniation of the uterus through the pelvic floor with a resultant protrusion into the vagina and at times even beyond the introitus. .

 3rd degree the entire uterus protrudes. without straining or traction.)  2nd degree the cervix extends over the perineum.Degrees  1st degree cervix.  Vaginal pessary temporary or palliative if surgery cannot be done. should be removed and cleaned every 1-2 months.  Abdominal sacropexy to anchor vagina  Estrogen cream to decrease genital atrophy changes . is at the introitus (spread the labia and it is visible. Management  Surgical correction is recommended treatment with an anterior and posterior repair. effective and permanent.

turtous opening between 2 internal hollow organs. or between an internal hollow organ and the exterior of the body.  Rectovagina fistula is an opening between the rectum and the vagina.  Ureterovaginal fistula is an opening between the ureter and vagina.  Vesicovagina fistula is an opening between the bladder and vagina.Vaginal Fistula  A fistula is an abnormal. .

Management        Intervention  Encourage frequent sitz baths. Treatment of postoperative fistulas may be delayed for 2-3 months to allow treatment of infection. Fecal or urinary diversion procedure may be required for large fistulas. it is connected to drainage tubing leading into a leg bag. Surgical closure of opening via vaginal or abdominal rout.  Recommend the use of vaginal irrigation. . Rarely. a fistula may heal without surgical intervention. done for patients who are not surgical candidates Prosthesis is inserted to the vagina. Medical approach: Prosthesis to prevent incontinence and allow tissue to heal.  Fistulas recognize at time of delivery should be corrected immediately.  Suggest patient use perineal pads or other incontinence products.

2 months  Estrogen therapy after menopause to decrease genital atrophy  Surgery If cytocele is a large and interferes with bladder functioning May do anterior vaginal colporrhaphy .  Should be removed and cleaned 1 .CYSTOCELE  Cystocele is a downward displacement (protrusion) of the bladder into the vagina.  Management  Vaginal pessary temporary treatment to support pelvic organs  Prolonged use may lead to necrosis and ulceration.

    Management Surgery if rectocele is large enough to interfere with bowel functioning posterior colpoplasty pessary estrogen level  Intervention  Teach patient to increase fluid and fiber intake.  Encourage use of stool softeners or bulk laxatives to make passage of stool easier.  Promote rest.Rectocele-Is displacement of the rectum into the vagina.  Suggest low Fowler s position to decrease edema and discomfort. .

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