| ID | 324 |
|---|---|
| Name | MISSED ABORTION |
| Cause | |
| Signs Symptoms | |
| Diagnosis | Differential diagnosis: 1. Ectopic pregnancy 2. Threatend abortion. 3. Metropathia hemorrhagica. |
| Investigations | Investigations: 1. Pregnancy test- negative after 7-10 days of the fetal death. 2. Ultrasonography shows no fetal movements. |
| Management | |
| Introduction | In this case fetus dies before 28th weeks of pregnancy in side the uterine cavity but fails to expell it out. So the dead product of conception remains in the uterine cavity. |
| History | |
| Etiology | |
| Clinical Features | Clinical features: 1. Signs/ symptoms of early pregnancy, followed by symptoms of threatened abortion. 2. Brownish sero-sanguinous discharge P/V. 3. Gradual retrogression of signs/symptoms of early pregnancy. 4. Internal os is closed & cervix feels firm. 5. Pregnancy test of urine becomes negative. |
| Preventions | |
| Treatment | Treament: 1. After waiting for 3 weeks (for spontaneous evacuation) attempt at induction of abortion should be taken. 2. Patient is admitted to the hospital. 3. Start oxytocin infusion with 5 units per litre & gradually increasing upto 100 units/litre. 4. If oxytocin infusion fails - it can be repeated after 1 week. 5. Prostaglandin vaginal tablets (500mcg/tablet) per vagina, (may be repeated 3 days later if products of conception are not expelled) are an effective alternative. 6. If the uterus is smaller than 12 weeks size of pregnancy, then dilatation & evacuation under G/A should be done. 7. Abdominal hysterectomy rarely done- when all other (above) efforts fail to evacuate the uterus. 8. Surgical induction is contraindicated due to risk of sepsis, clostridium infection. |
| Complications | Complications: 1. Psychological disturbance. 2. Sepsis. 3. Hypofibrinogenemia (Rx- whole fresh blood transfusion or fibrinogen administration 5-10gm or triple concentrated plasma or epsilon amino caproic acid 4-5gm orally or i.v slowly. |
| Prognosis | |
| Types | |
| Classification | |
| Observation | |
| Pathology |
© Pakistan Drug Directory. All Rights Reserved.
Designed By: Pakistan Drug Directory Team