Abortion - Good

7/30/2019 Abortion - Good

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Abortion

2nd Group :

Esmy MaulidyaNurlailatul Khairiyyah


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Abortion is the termination ofpregnancy by the removal or expulsionfrom the uterus of a fetus or embryoprior to viability.
http://en.wikipedia.org/wiki/Pregnancy_(mammals)http://en.wikipedia.org/wiki/Uterushttp://en.wikipedia.org/wiki/Fetushttp://en.wikipedia.org/wiki/Embryohttp://en.wikipedia.org/wiki/Fetal_viabilityhttp://en.wikipedia.org/wiki/Fetal_viabilityhttp://en.wikipedia.org/wiki/Embryohttp://en.wikipedia.org/wiki/Fetushttp://en.wikipedia.org/wiki/Uterushttp://en.wikipedia.org/wiki/Pregnancy_(mammals)


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Spontaneous Abortion

Provokatus abortion (abortion that

deliberately)

Abortion classification


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Abortion Imminens

Abortion insipiens

Incomplete abortion

Complete Abortion

Spontaneous Abortion


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Handling imminen abortion

- Take a rest

- Progesterone therapy by IM

- Ultrasound examination


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Abortion insipiens handling

If less than 16 weeks gestational age, evaluate the uterine manualvacuum aspiration.If the evaluation is not possible, then immediately do:

a. Give ergomefiin 0.2 mg intramuscularly (can be repeated after 15minutes if necessary) or 400 mcg of misoprostol orally (can berepeated after 4 hours if necessary).

b. Immediately do preparation for spending the products of conception

from the uterus. If the gestational age over 16 weeks:

Wait for spontaneous expulsion of products of conception andevaluation of the remnants of the products of conception.

If necessary, infusion of 20 units of oxytocin in 500 ml of intravenousfluids (normal saline or Ringer's lactate solution at a rate of 40 drops perminute to help the expulsion of the products of conception.

Be sure to keep track of the condition of women after treatment


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Handling of incomplete abortion If the bleeding is not how much or less 16 weeks gestation, the evaluation can be done

digitally or with ovum forceps to remove products of conception exit through thecervix. If the bleeding stops, give ergometrin 0.2 mg intramuscularly or 400 mcg of

misoprostol orally.

If the bleeding continues and more or less than 16 weeks gestational age, the

evaluation of the products of conception:

a. manual vacuum aspiration is an evaluation method selected. Evacuation with sharp

curettage should only be done if the manual vacuum aspiration is not available.b. If evacuation can not be performed immediately make ergometrin 0.2 mg

intramuscularly (repeated after 15 minutes if necessary) or 400 mcg of

misoprostol orally (can be repeated after 4 hours if necessary).

If the pregnancies over 16 weeks:

a. Provide an infusion of oxytocin 20 units in 500 ml of intravenous fluids (normal

saline or Ringer's lactate) at 40 drops per minute until the expulsion of theproducts of conception occurs

b. If necessary given misoprostol 200 mcg vaginally every 4 hours until the expulsion of

the products of conception occurs (maximum 800 mcg)

c. Evaluation of residual products of conception in the uterus.

d. Make sure to keep track of the condition of women after treatment.
http://en.wikipedia.org/wiki/File:Vacuum-aspiration_(single).svg


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Complete Abortion

Clients with abortion kompletus not

require special treatment, only if the patient

needs to be given tablets sulfas anemia

ferrosus 600 mg per day or if the anemia is

severe then it should be given a blood

transfusion.


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Provokatus abortionAbortion provokatus is event stop

pregnancy before the fetus can live outside

the mother's body


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Etiologi

Fetal Factors

Mothers factor

The use of drugs and environmentalfactors

Immunological Factors


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PathophysiologyPathophysiology of abortion starts

bleeding in the decidua that cause necrosis of

the surrounding tissue. Then part / whole

fetus will detach from the uterine wall. This

situation is a foreign body to the uterus,

thereby stimulating uterine contractions to

occur eksplusi fatus often invisible and iscalled "Bligrted Ovum".


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Gynecological examination

inspection Vulva

Inspekulo

vaginal plug


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Complication

1. Bleeding (haemorrhage)2. perforation3. Infection and tetanus

4. acute renal failure5. Shock, shock caused by hemoreagrie(bleeding a lot) and septic shock or endoseptik(severe infection or septic)

6. In the missed abortion with retention oflong products of conception can occur clottingdisorders


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Management of Abortion

1. surgical technique

a. Kuretose / dilation

b. Menstrual aspirationc. Laparotomy

2. medical techniques


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Nursing Diagnosis

1. The risk of fluid volume deficit related to

hemorrhage2. Activity intolerance related to weakness.

3. Pain related to intrauterine tissue damage.

4. The risk of infection is related to bleeding,the vulva moist conditions.


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Thanks forNurse

Billahi FiiSabilil Haq

FastabiqulKhairat

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Abortion - Good