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Last reviewed: 04.07.2025
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An abortion in progress is characterized by cramping pains in the lower abdomen, severe bleeding. The fertilized egg is in the cervical canal, its lower pole can protrude into the vagina. An abortion in progress can end in incomplete or complete abortion.
In case of incomplete abortion, when the fertilized egg is partially expelled from the uterine cavity, cramping pains in the lower abdomen and bleeding of varying intensity are observed. The cervical canal is open by one finger. The uterus is soft. Its size is smaller than it should be for the expected gestational age. The fetal membranes, placenta or part of it are usually retained in the uterus.
Since incomplete abortion is often accompanied by heavy bleeding, emergency care is required. Upon admission to the hospital, a blood test must be done to determine the blood type and Rh factor. It is necessary to stabilize the patient's condition by starting intravenous infusion of blood substitutes. It is advisable to administer intravenous saline with oxytocin (30 U of oxytocin per 1000 ml of solution) at a rate of 200 ml per hour (in the early stages of pregnancy, the uterus is less sensitive to oxytocin).
Since oxytocin can cause an antidiuretic effect after uterine evacuation, the administration of such doses of oxytocin should be discontinued. The remains of the ovum are removed with an abortion forceps, vacuum aspiration or curettage is performed. After removal of the remains of the ovum, antibacterial therapy is prescribed, if necessary, treatment of posthemorrhagic anemia. Patients with Rh-negative blood should be given anti-Rhesus immunoglobulin.
In a complete abortion, which is more often observed in the later stages of pregnancy, the fertilized egg leaves the uterine cavity. The uterus contracts, bleeding stops. During a bimanual examination, the uterus is well contoured, smaller in size than the gestational age, the cervical canal may be closed.
In case of complete abortion in the gestation period up to 14-16 weeks, it is advisable to perform curettage of the uterine walls, since there is a high probability that parts of the fertilized egg may be in the uterine cavity. At a later stage, with a well-contracted uterus, curettage is not performed, it is advisable to prescribe antibiotics, treat anemia and administer anti-Rhesus immunoglobulin to patients with Rh-negative blood.