Abortion: Everything You Need To Know
Abortion is the termination of pregnancy or the loss of a fetus/embryo. The risk of spontaneous abortion (also known as miscarriage) is high in the start of pregnancy. Mostly, miscarriages happen in the first trimester i.e. the first 12 weeks of gestation period. The early weeks of pregnancy before the 20th week is the time when a woman is at the highest risk of miscarriage. The risk starts to drop when pregnancy reaches the 6th month i.e. 24 weeks.
While abortion is a safe intervention when carried out by health care professionals, it is better to keep in mind that complications can arise at any point in the whole pregnancy period.
Classification of Abortion
- Early abortionIt is the removal of undesired tissues in the first trimester in the 10-14th week of confirmed pregnancy through pills.
- Late abortionThe abortion after the 24th week of pregnancy is called late abortion. This type of abortion is recommended by a doctor only if it poses a threat to a woman’s life.
- Spontaneous abortionThe unintentional death of the fetus before 20 weeks of pregnancy is known as spontaneous abortion.
- Induced abortionThe intentional removal of embryo through medication or instruments in case of unwanted pregnancy is induced abortion.
- Threatened abortionThreatened abortion is marked by vaginal bleeding that occurs in the first trimester which could be sign of possible miscarriage.
- Inevitable abortionThis is a condition in which profuse vaginal bleeding occurs and the cervix has become dilated. The membranes show gross rupturing. This is an indication of that abortion is certain. The symptoms of inevitable abortion are intrauterine pregnancy with worse cramps, high vaginal bleeding and cervix dilation that results in miscarriage.
- Complete abortionComplete abortion happens during the 8th week, when all the tissues leave the body and pass through the vagina with bleeding.
- Incomplete abortionWhen some of the tissues leave the body and some tissues stay in the body, this condition is called incomplete abortion.
- Recurrent abortionAlso known as recurrent pregnancy loss (RPL), or recurrent miscarriage, recurrent abortion is three consecutive miscarriages in less than 20 weeks is considered as recurrent abortion.
- Missed abortionWhen the fetus didn’t form or has died but the tissues remain in the uterus is missed abortion.
- Septic abortionThis type of abortion is associated with a uterine infection that can spread to the placenta and fetus before and after induced abortion and can develop sepsis in the uterus, placenta, fetus and vital organs. It is usually caused by pathogens of the bowel or vagina.
Causes of Abortion
A list of problems that could result in abortion are
- Viruses such as Cytomegalovirus, Herpes virus, Parvovirus and Rubella virus.
- Immunologic abnormalities.
- Major trauma.
- Polycystic ovary syndrome.
- Inherited thrombophilias.
- Uterine abnormalities like fibroids and adhesions.
- Placental defects.
- Cervix problems.
- Retroverted uterus.
- Multiple pregnancy.
- Hormonal problems in mother.
- Uncontrolled diabetes.
- Thyroid disorders.
- Abnormal fetal growth.
These defects in the genes and chromosomes of the mother or father occur naturally and do not promote fetal growth.
Embryo division or damaged cells are also natural causes of abortion.
Risk Factors Involved in Abortion
Certain risk factors that can lead a woman to miscarriage are
- Age greater than 35.
- History of spontaneous abortion.
- Tobacco consumption.
- Use of alcohol, drugs (eg. cocaine).
- Chronic disorders in the mother like diabetes, hypertension etc.
- High caffeine intake.
- Uterine and cervix problems.
- Excess weight.
- Invasive prenatal tests.
- Poor diet or malnutrition.
- Advanced maternal age.
- Abnormally shaped uterus.
- Food poisoning.
- Exposure to toxins like arsenic, lead, etc.
- Use of certain medications.
Prevention of Miscarriage
Some tips for avoiding a miscarriage are
- Regular exercise like jogging, walking or cycling.
- Regular prenatal follow-ups.
- Avoid smoking.
- Avoid drug use.
- Reduce alcohol intake.
- Intake of prescribed multivitamin.
- Limit caffeine intake during the pregnancy but it’s better to avoid it.
- Maintenance of a healthy weight.
- A healthy and balanced diet with all nutrients and minerals in every meal.
- Avoid things that might develop infections.
- Addition of fruits and green vegetables in your daily diet.
- Maintain a happy and calming environment, find ways of managing your stress.
Diagnosis of Abortion
The tests that are carried out for diagnosis of abortion are
- Transvaginal ultrasonography.
- Transabdominal ultrasonography.
- Serum HCG test.
Treatment for Abortion
Usually women who have had an abortion have 3 treatment options other than a complete abortion
- Expectant managementDoctors wait for the rest of the tissue to pass out naturally in this type of treatment.
- Medical managementThis treatment option requires medication to remove the remaining tissue from the body.
- Surgical managementThis treatment option requires a surgical procedure to remove the tissues remains if any.
When to see a doctor?
During and after a miscarriage, the main goal of treatment is to prevent excessive bleeding and infection. If vaginal bleeding exceeds, call your doctor immediately.