Abortion Or Miscarriage
Abortion or miscarriage is the expulsion or extraction of a fetus weighing less than 500 grams from mother’s womb. Before proper implantation itself it’s found that about 20% of all pregnancies end in abortion, these go unnoticed.
CAUSES OF ABORTION:
Fault with embryo: About two third of the abortion are known to be because of chromosomal defects in embryo. In certain cases defect in the placenta causing death of the fetus.
Fault in the maternal environment:
• Maternal diseases causing high fever.
• Rh-ve pregnancy.
• Physical trauma, e.g. a blow on the abdomen or that caused by a fall.
• Infections by toxoplasma (common) or by Listeria monocytogenes.
• Surgical trauma due to any operation.
• Hormonal deficiencies as in progesterone deficiency in corpus luteum defect, or in hyperthyroidism or hypothyroidism.
• Cervical Incompetence
• ABO incompatibility
• Uterine fibroid causing improper implantation of the placenta.
• Congenital malformations of the uterus like hypoplastic uterus, unicornuate, bicornuate uterus, septate uterus etc.
SIGNS AND SYMPTOMS:
• The chief symptoms of abortion are pain and bleeding. Whether pain occurs first or bleeding will depend on whether the abortion is due to death of the fetus or abnormal uterine bleeding.
• If the death of the fetus occurs first, the woman will notice bleeding as her first symptom due to separation of embryo + early placenta and membranes from the uterine wall.
• Then Pain occurs as the uterus starts to contract to expel the embryo + early placenta and membranes. This pain is known to increase. Pain cease once expelled completely.
• If the abortion is due to abnormal uterine activity then pain occurs first followed with bleeding. If the fetus is around 18-20 weeks of gestation, it may even be born alive at the time of the abortion.
• A mild haemorrhagic discharge, somewhat similar to the lochia seen after childbirth continues for a few days, then gradually ceases.