Abortion and safe abortion care: (Episode 1)

Phew 😅. It’s been a hell of a month for me in the department of Obstetrics and Gynecology. I mean I got to learn quite a lot of things and the principal of all the things I learnt was that women are very strong beings and they go through a lot. So if you have a girl or woman by your side make her know this as frequently as possible that she is a queen and deserves to or adored.

Well from now on I’ll be making exciting post about what I learnt in the department of Obstetrics and Gynecology as initially promised. My first post would be on “Abortion and Safe abortion care.”

Ps: This post would be divided into 2 series. 1st series would be on Abortion and what it means. 2nd series would be on Safe abortion and care.

HERE WE GO

Introduction:

Many pregnancies are lost in early weeks than at any other stage of gestation. Though early pregnancy losses are often considered to be less important than the loss of the baby in later pregnancy, the loss of a wanted pregnancy is always distressing to the mother irrespective of the timing. This is particularly true in recurrent abortions
ABORTION is one of the complications of early pregnancy and can either be spontaneous or induced. It is defined as “the termination of pregnancy before the period of fetal viability; usually taken in our environment to be the 28th week of gestation.
The World Health Organization (WHO) defined it as “pregnancy termination prior to 24 weeks gestation or the expulsion or extraction from its mother of a fetus weighing less than 500gm.

Why is Abortion or any relevance?

Abortion is really important because the rate of sexual activity amongst youngsters have risen to a significant high and with that comes an increased rate of unwanted/unplanned pregnancy leading further to an increase in the numbers of abortions worldwide
WHO estimates that about 46 million cases of abortions occur annually. This helps to buttress my point.
The subject matter is of high value because amongst this rising numbers of abortions cases estimated by WHO, 90-95% occurs in developing countries and more than 80% of these are unsafe. ( Based in the survey conducted by WHO)

The aim of this post is to inform my readers about abortion and what it entails as well as state the various risk associated with abortion while also advising on the need to prevent its occurrence.

Let’s continue.🙂

Clinical Variations of Abortions

• Threatened abortions
  A threatened abortion is defined as virginal bleeding that occurs in the first 20 weeks of pregnancy (usually the first trimester). The bleeding sometimes is accompanied abdominal cramps. It is in most cases thought to be implantation bleed. The Characteristic finding is that the Cervical os is closed.

• Inevitable abortions
  This is an early pregnancy with vaginal bleeding and dilatation of the cervix accompanied by effacement. There is usual painful uterine contractions. The Characteristic finding is that the Cervical os is opened!

• Incomplete abortions
  This is a pregnancy that is associated with vaginal bleeding, dilatation of the cervical canal, and incomplete passage of products of conception including membranes and placenta. Abdominal cramps are usually present and bleeding is generally persistent and is often severe.

• Complete abortions
  This is a type of abortion in which all the products of conception have been expelled and the cervical is is closed. Uterine contractions and pain ceases.

• Missed abortions
  This occurs when the fetus dies but the gestational sac is retained in the uterus for several weeks or months. There is disappearance of symptoms of pregnancy

• Septic abortions
  This defined as an infection of the placenta and fetus of a previable pregnancy. The commonest infecting organisms are Staphylococcus Aureus, Coliforms, Bacteriodes, Clostridium welchii. Infections may spread to nearby structures like the uterus , pelvis causing generalized peritonitis, pelvic cellulitis and the rest. It is usually associated with fever, offensive Vaginal discharge, Pelvic and abdominal pain

• Habitual abortions
  This is a term given to any case in which there has been three or more consecutive a spontaneous miscarriages. It is found very commonly in habitual/intentional aborters.

Ps: I’ve intentionally left out induced abortion form the list of clinical variation of abortions since it’s the focus of this post.

Moving on

INDUCED ABORTIONS

This is defined as deliberate steps taken to end or terminate a pregnancy before the period of fetal viability. Usually 20 weeks for WHO, 24 weeks for America and 28 weeks for Nigeria. When properly done, induced abortion is one of the safest procedures in medicine, but unsafe induced abortion is a major cause of maternal mortality, especially in the developing countries like my own, Nigeria.

This procedure can be through;

• intake of drugs to terminate the pregnancy ( or,
• Surgical procedures.

COMPLICATIONS OF UNSAFE ABORTIONS.

• Consistent bleeding
• Infection
• Uterine peforations
• Damage of genital tracts and internal organs
• Incomplete abortions

More on this would be on my next post.

CONCLUSION

Abortion is a clinical procedure that should not be done unless very necessary. As such it is advised that careful family planning as well as preconception care be carried out before a pregnancy occurs between two partners. If an abortive process must occurs it must be safe to avoid any of the complications listed above.