Abortion by Dr rahat

1. ABORTION
1.SPONTANEOUS ABORTION
• Threatened abortion
• Inevitable abortion
• Incomplete abortion
• Complete abortion
• Missed abortion
• Septic abortion
2.RECURRENT ABORTION
3.INDUCED ABORTION

2. RECURRENT ABORTIONS
• It is also known as habitual or
repeated abortion.It is defined as
three or more consecutive
spontaneous abortions.Approx 1
in 100 women experience it.

3. AETIOLOGY
1 Genetic factors.
a) chromosomal abnormalities (structural abnormalities) are
mainly associated with recurrent abortions.These
abnormalities are three times more common in
females.Most common chromosomal abnormalities are:
1.Robertsonian translocation.
2.Reciprocal translocation.
3.Inversion.
4.Chromosomal mosaicism.
b) Neural tube defects and Potter’s syndrome increases
incidence of abortion.

4. • 2.Anatomical factors.
• a) Congenital anomalies of uterus are present in
10-15% of cases.These include bicornuate ,
subseptate,unicornuate uteri.The mechanism
through which these cause abortion is not clear
though implantation on septum may lead to
decreased plancental vascularization.
• b) Intra uterine adhesions are also responsible
presumably due to inadequate placentation.
• c) Fibroid uterus.
• d) Incompetent cervix.

5. • 3.Endocrinal factors.
• a) Polycystic ovarian disease.
• b) Corpus luteum insufficiency.
• c) Diabetes mellitus.
• d) Thyroid dysfunction.

6. • 4.Immunological factors.
• a) Alloimmune factor e.g production of
suppressor cells within decidua,blocking
antibodies, trophoblastic leucocyte cross
reacting antigens.
• b) Auto immune diseases e.g in SLE , lupus
anticoagulants, cardiolipins antibodies appear
before clinical onset of disease which
increases incidence of recurrent abortion.

7. • 5.Systemic Disorders e.g hypertension and
renal disease.
• 6.Smoking and Alcohol.The risk of abortion
is doubled in these patients.

8. Management.
History.
Examination.
Investigation in non- pregnant woman.
1.Karyotyping
2.Ultrasound
3.Hormonal assays
4.Biochemistry
5.Blood tests
6.TORCH studies
7.Antibody tests

9. Investigation in pregnant woman.
Beta hCG
Estradiol levels
Progesterone
Ultrasound
Alpha feto proteins
Chorion Villous Sampling, amniocentesis.

10. Treatment
• Counselling is most important part of
management during or before next
pregnancy.
• During pregnancy general treatment includes
• Rest
• Nutrition
• Specific intervention
• Cervical incompetence
• Before next pregnancy causative factor is
found and patient is treated accordingly.