Pathophysiology The fetal or placental defect or the maternal condition results in the disruption of blood

flow, containing oxygen and nutrients, to the developing fetus. The fetus is compromised and subsequently
expelled from the uterus.
D. Assessment Findings
1. Associated findings The client and family may exhibit a grief reaction at the loss of pregnancy,
including:
a. Crying
b. Depression
c. Sustained or prolonged social isolation
d. Withdrawal
2. Clinical Manifestations include common signs and symptoms of spontaneous abortion.
a. Vaginal bleeding in the first 20 weeks of pregnancy
b. Complaints of cramping in the lower abdomen
c. Fever, malaise or other symptoms of infection
3. Laboratory and diagnostic study findings
a. Serum beta hCG levels are quantitatively low
b. Ultrasound reveals the absence of a viable fetus.
E. Implementation
1. Provide appropriate management and prevent complications
a. Assess and record vital signs, bleeding and cramping of pain.
b. Measure and record intravenous fluids and laboratory test results. In instances of heavy
vaginal bleeding; prepare for surgical intevention (D & C) if indicated.
c. Prepare for PhoGAM administration to an Rh-negative mother, as prescribed. Whenever
the placenta is dislodged (birth, D & C, abruptio) some of the fetal blood may enter
maternal circulation. If the woman is Rh negative, enough Rh-positive blood cells may
enter her circulation to cause isoimminization, the production of antibodies against Rhpositive blood, thus endangering the well-being of future pregnancies. Because the
blood type of the conceptus is not known, all women with Rh-negative blood should
receive RhoGAM after an abortion.
d. Recommended iron supplements and increased dietary iron as indicated to help prevent
anemia.
2. Provide client and family teaching
a. Offer anticipatory guidance relative to expected recovery, the need for rest and delay of
another pregnancy until the client fully recovers.
b. Suggest avoiding intercourse until after the next menses or using condoms when
engaging in intercourse.
c. Explain that in many cases, no cause for the spontaneous abortion is ever identified.
3. Address emotional and psychosocial needs.
In nursing care plan for abortion definitions for Abortion is: Spontaneous abortion, miscarriage, or induced
abortions, the products of conception are expelled from the uterus before fetal viability and gestation of less than 20
weeks is achieved.
Causes for Abortion
Its May result from fetal, placental, or maternal factors:

Fetal factors usually include defective embryologic development resulting from abnormal
chromosome division (the most common cause of fetal death), faulty implantation of fertilized ovum, and
failure of the endometrium to accept the fertilized ovum, usually cause such abortions between 9 and 12
weeks of gestation

Placental factors usually include premature separation of the normally implanted placenta,
abnormal placental implantation, and abnormal platelet function. Usually cause abortion around the 14th
week of gestation.

Maternal factors usually include maternal infection, severe malnutrition, and abnormalities of the
reproductive organs. usually cause abortion between 11 and 19 weeks of gestation
Other maternal factors include endocrine problems, such as thyroid gland dysfunction or lowered estriol secretion, trauma,
including any type of surgery that necessitates manipulation of the pelvic organs, blood group incompatibility and Rh
isoimmunization, and recreational drug use and environmental toxins.
Therapeutic abortion is performed to preserve the mother's mental or physical health in cases of unplanned pregnancy, or
medical conditions, such as cardiac dysfunction or fetal abnormality.
Complications that may happen in Nursing Care Plan for Abortion

Infections in case of the products of conception aren't completely expelled

Hemorrhage

Anemia

Coagulation defects such as disseminated intravascular coagulation

Assessment Nursing Care Plan for Abortion

Pink discharge for several days or a scant brown discharge for several weeks

Cramps and increased vaginal bleeding

If any contents remain, cramps and bleeding continue.

Assess the patients emotional status, as well as that of the babys father and other family members. Often this hospital
admission is the first one for the patient, and it may cause anxiety and fear
Diagnostic tests Nursing Care Plan for Abortion

HCG in the blood or urine confirms

Decreased HCG level

Laboratory test results reflect a decreased hemoglobin level

Ultrasound examination; absence of fetal heart sounds

Nursing diagnosis
Primary Nursing Diagnosis found in Nursing Care Plan for Abortion
Anticipatory grieving related to an unexpected pregnancy outcome
Common nursing diagnosis found in Nursing Care Plan for Abortion

Anxiety

Disabled family coping

Dysfunctional grieving

Hopelessness

Powerlessness

Risk for infection