NURSING

1. WELCOME
PRESENTER NAME;
MISS.LAXMI RAWAT
4th YEAR BSC NSG(MCN)
EVALUATOR NAME;
MRS. SNEHLATA PARASHAR
LECTURER

4. INTRODUCTION :-
 Abortion is also k/a miscarriage
 Abortion is the ending of pregnancy By removing a
fetus or embryo Before it can survive outside the
Uterus ,if the fetus or wt is less than 500gm at 20
weeks of gestation. The expelled embryo or fetus is
called abortion .
 It may be induced or spontaneous .

5. DEFINITION
ACCORDING TO K. NILAM ; Abortion is termination of
pregnancy by any means before the fetus is
sufficient to developed to survive
 ACCORDING TO NINA BHASKAR ; An abortion
is the premature expulsion of products of
conception from uterus it can be either
spontaneous or induced .

6. INCIDENCE :-
 The number of abortion
performed world wide
with
41.6 million in 2003
43.8 million in 2009

7.  In india about 6 million abortion are take place ,
2 million abortion are spontaneous and 4 million
Induced .
 38,000 death from unsafe abortion unusually
World wide ……..

8. CAUSES OF ABORTION:-
MATERNAL CAUSES;
1.Maternal
infection
2.Maternal disease
3.Drugs
4.Hormonal
disturbance
FETAL CAUSES;
Chromosomal
anomalies
Blighted ovum
Hydatidiform
moles
Congenital defect

9. OTHER CAUSES:-
• Uterine developmental anomalies
• Retroversion
• Fibromyomaof uterus
• Surgery during pregnancy.
• Environmental factors-cigarette,alcohol
• Immune factors- Rh-ve blood

12.  THREATENED ABORTION:-
It is a clinical entity where choriodecidual
Hemorrhage has begun , but not progressed
To the stage of irreversibility , this means the
Cervix is not open and the product of concept-
-ion ,are not expelled .Baby survival is possible
C/M:-painless vaginal bleeding without uterine
contraction,cervix is soft.
D/A:-blood,urine,usg ,thyroid FT.
T/T:- HRT,HCG inj.,Analgesic….

14.  INEVITABLE ABORTION:-
In this type of abortion the process has begun
$ progressed to such an extent that expulsion
Of the product of conception seems inevitable .
Continuation of pregnancy is impossible .
C/M:- vaginal bleeding with clot or product of
Conception .
D/A:- H/C, vaginal exam. ,blood,USG,
T/T:-less than 12 weeks –suction evacuation
more than 12 weeks –oxytocin 10unit 500ml NS

18. MISSED
ABORTION

19. SEPTIC
ABORTION

20. PATHOLOGY:-
In the majority 80%,the organism are of endogenous
Origin and the infection is localized to the conceptus
Without any myometrium involment .
in about 15% , the infection either produces localized
endomyometritis Surrounded by a protective leukocytic
barrier or spread
To the parametrium tubes ovaries or pelvic peritoneum .
In about 5% , there is generalized peritonitis and
endotoxic shock .

21. NURSING MANAGEMENT:-
 Preoperarive care:--
 Postoperative care :--
 Health education :-
• DIET :-fresh fruits pulses , cereals , wholes
Avoid smoking ,refined food .
• EXERCISE:- Avoid heavy work and heavy
exercise
• HYGIENE:- maintain perineal hygiene .

22.  MEDICAL TERMINATION OF PREGNANCY
ACT (1971):-
• MTP is a medical termination of pregnancy .Its also
known as induced abortion .It is the medical way to
getting rid of Unwanted pregnancy .
• The termination of a pregnancy by the
removel or exoulsion of an embryo or fetus
from the uterus ..

23. QUALIFICATION FOR MTP;
 Assist 25 cases of mtp in approved
institution
 6 month housemanship in OBG.
 PG qualification in OBG.
 3yrs practices in OBG .

24. PLACE FOR MTP;
 Place established and maintain
ed by govt.
 Non govt. institution can perfo
rm, they obtain licence from CMO
Of distict

25. INDICATION FOR MTP:-
Risk of injury to mental $ physical health of
Woman
Abnormalties in fetus .
Pregnancy caused by rape .
Contraceptive failure .

26. METHOD OF TERMINATION :-
1st trimester :-
MEDICAL – Mifepristone + Misoprostol
methotrexate +misoprostol
tamoxifam +mosoprostol
SURGICAL –vaccum aspiration
suction evacuation
dilatation and curettage

27. 2nd trimester –
MEDICAL – misoprostol, carboprost
SUGICAL – and curettage ,
• D/C
• Hystrectomy Hysterectomy .

29. COMPLICATION:-
i. Injury to the cervix
ii. Uterine perforation
iii. Hemorrhage and shock
iv. Menstrual disturbance
v. Chronic pelvic inflammation etc.