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Treatment of abortion while on the move
Last reviewed: 20.11.2021
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Abortion in the course is characterized by cramping pains in the lower abdomen, marked by bleeding. The fetal egg is in the cervical canal, its lower pole can protrude into the vagina. Abortion in transit may result in incomplete or complete abortion.
With incomplete abortion, when the fetal egg is partially expelled from the uterine cavity, cramping pains in the lower abdomen and bleeding of different intensity are observed. The canal of the cervix is open on one finger. Uterus of soft texture. Its magnitude is less than it should be with the expected duration of pregnancy. In the uterus, the fetal membranes, the placenta, or part of it are usually retained.
Due to the fact that incomplete abortion is often accompanied by heavy bleeding, it is necessary to provide emergency care. When entering the hospital, you need to do a blood test, determine the blood group and Rh-accessory. It is necessary to stabilize the patient's condition by starting an intravenous infusion of blood substitutes. It is advisable to inject iv physiological solution with oxytocin (30 units 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).
Due to the fact that oxytocin can cause an antidiuretic effect after emptying the uterus, the administration of such doses of oxytocin should be discontinued. Abortion removes the remains of the fetal egg, produces vacuum aspiration or curettage. After removal of the remains of the fetal egg, antibacterial therapy is prescribed, if necessary, treatment of posthemorrhagic anemia. Patients with Rh-negative blood need to introduce immunoglobulin antiresus.
With full abortion, which is more often observed in late pregnancy, a fetal egg leaves the uterine cavity. The uterus contracts, the bleeding stops. In bimanual examination, the uterus is well contoured, the size is less than the gestation period, the cervical canal can be closed.
With full abortion at the gestational age of 14-16 weeks, it is advisable to scrape the walls of the uterus, since it is more likely that parts of the fetal egg can be in the uterine cavity. In later terms, with a well-contracted uterus, scraping does not produce, it is advisable to prescribe antibiotics, treat anemia and inject an immunoglobulin against antiresusis in patients with Rh-negative blood.