INTRODUCTION

DEFINITION:
 A process where a woman has threat or termination of
(intrauterine) pregnancy by any means below 28 weeks (7
months) safely or unsafely.
 More than half of abortions in developing country are
unsafe.
 It may occur legally (where the law permits) or illegally in
safe, less safe, unsafe and very unsafe situations.
 One of a major contributing factor to maternal mortality
rate (maternal death) with epidemiological evidence as a
public health problem nation-wide and globally.
 CLASSIFICATION:
It may be spontaneous or induced.
 Spontaneous – Occurring naturally
 Induced – Using artificial means to cause termination
1. According to the outcome ie. Safe or unsafe
2. Clinically
 Threatening
 Complete
 Incomplete
 Missed
 THREATENING:
Occurs when woman experience vaginal bleeding or other signs of
miscarriage but miscarriages has not occurred.
 COMPLETE:
Here, all the products of conception has been expelled
 INCOMPLETE
Occurs when some of the products of conception (Fetal and
Placental tissues) have been expelled from the uterus but some remain
within the uterus (womb)
 MISSED ABORTION
Occurs when the foetus has not developed so there is no viable
pregnancy but there is placental tissue within the uterus.
 CAUSES OF ABORTION
These include
 Maternal Conditions
Eg. - Infections
 Uterine defects
 Cervical incompetency
 Malaria

 Foetal Conditions
Eg. - Maldevelopment of ovum,
 Chromosomal abnormalities ie X and Y chromosomes
 Defective implantation
 Underlying causes eg nutritional status
TOOLS USED FOR ABORTION (UNSAFE)
 Aligator pepper (fomwisa)

 Chalk

 Alum

 Cassava plant

 Bahamas grass

 Quinine and other drugs

 Bleach

 Bicycle spoles, etc

 DIAGNOSIS OR IDENTIFICATION
OF ABORTION

It can be identified by

 Patient presentation
 Comprehensive history taking and physical
examination
 Laboratory test and radiological assessment
COMPLICATIONS:
 SHORT TERM COMPLICATIONS INCLUDES
 Retained product of conception
 Haemorrhage (bleeding)
 Instrument injury
 Shock

 LONG TERM COMPLICATIONS

 Pelvic inflammatory disease
 Tubal occlusion (tubal blockage)
 Infertility
 Ectopic pregnancy
 Chronic pelvic pain
 MANAGEMENT OF ABORTION

This is done according to gestational age and

classification using National guidelines.

All abortions occurring at <12 weeks – Manual Vacuum

Aspiration (MVA) and those occurring> 12 weeks do

uterine evacuation (D&C) Dilatation & Curettage and

this include:

 History taking and full physical examination

 Post abortion care

PREVENTION
 Counseling and Health education
 Access to Family Planning Methods
 Antenatal Services – Screening for risk groups

REFERENCES
 WHO Systemic Review of Causes of Maternal
Death
 US Agency for International Development
 Life Saving Skills Manual.
THANK YOU