Abortion threatening

Abortion is menacing. Patients complain of mild pain in the lower abdomen and in the lumbar region. There are no bloody discharge from the genital tract, the size of the uterus corresponds to the term of pregnancy, the external zev is closed (with ischemic-cervical insufficiency ajar). This condition is considered reversible, and with successful treatment, pregnancy develops later normally. Abortion started is characterized by increased pain, the appearance of scanty smearing bloody discharge from the vagina. The size of the uterus corresponds to the period of pregnancy, the outer yawn is closed or slightly ajar. Pregnancy can still be saved, but the prognosis is worse than with a threatening abortion. Abortion in the course, a fetal egg, exfoliated from the uterus wall, is expelled from it through the cervical canal. Patients complain of cramping pain in the lower abdomen and bleeding (sometimes significant). The size of the uterus corresponds to the term of pregnancy or is smaller. With a vaginal examination, the cervix is ​​smoothed or open, c. Lumen it palpate spongy tissue (a fetal egg and blood clots).

Preservation of pregnancy is impossible. Partial abortion is characterized by a delay in the uterine cavity of the parts of the fetal egg and is accompanied by bleeding, often significant. Isolated blood clots and parts of the fetal egg. With vaginal examination: the cervical canal is slightly open, the size of the uterus is less than it should be according to the term of pregnancy. Abortion is more common in early pregnancy. The uterus is free from the remains of the fetal egg, it contracts, the cervical canal closes and the bleeding stops.

Treatment of spontaneous abortion is carried out depending on its stage. With a threatening and started abortion, the patient is placed in a hospital where bed rest is provided. Vaginal examinations, as they stimulate the contractile activity of the uterus, are performed only on strict indications. Of great importance is psychotherapy, eliminating negative emotions and positively affecting the development of pregnancy. Drug therapy consists in the appointment of sedatives and hypnotics (at night), progesterone 5-10 mg per day for 10-15 days, or turinale 2 - 3 tablets (10-15 mg per day) for several weeks, vitamin E 200 μg2-3 times a day, ascorbic acid for 100-200 mg per day, antispasmodic drugs (no-spleed to 0.04 g 3 times a day, suppositories with papaverine hydrochloride 0.02 g 3-4 times a day) . In the case of severe pain, no-shpa is injected with 2 ml of a 2% solution v / m 2-3 times a day, baralgin at a dose of 2 ml IM. Candles with belladonna are contraindicated because of the property of this drug to expand the cervix!

With infantilism, ovarian hypofunction, simultaneous use of estrogens and progesterone is recommended. The introduction of diethylstybestrol is contraindicated because of the danger of transplacental carcinogenesis! If the function of the adrenal cortex (hyperandrogenia) is disturbed, prednisolone is prescribed for 10 mg for 8-10 days, then 5 mg for 20 days. With abortion in the course and incomplete abortion, instrumental removal of the fetal egg or its parts is shown. With late abortion, not accompanied by significant bleeding, waiting for spontaneous birth of the fetal egg - scraping of the uterus is indicated in case of delay in the uterus of the placenta parts. In case of a threatening or beginning abortion, caused by ischemic-cervical insufficiency, surgical treatment is necessary to eliminate the pathological expansion of the isthmus and internal uterine throat.