termination of pregnancy before the fetus is viable. In the medical sense, this term and the term miscarriage
both refer to the termination of pregnancy before the fetus is capable of survival outside the uterus. The term abortion
is more commonly used as a synonym for induced abortion,
the deliberate interruption of pregnancy, as opposed to miscarriage, which connotes a spontaneous or natural loss of the fetus. Because of this distinction made by the average layperson, care should be exercised in the use of the word abortion when speaking of a spontaneous loss of the fetus.
The technique chosen to terminate pregnancy depends on the stage of pregnancy and the policies of the institution and patient needs. It is rare for a fetus to survive if it weighs less than 500 g, or if the pregnancy is terminated before 20 weeks of gestation. These factors are, however, difficult to determine with a high degree of accuracy while the fetus is still in utero;
survival of the fetus delivered near the end of the second trimester often depends to a great extent on the availability of personnel and equipment capable of supporting life until the infant develops sufficiently.
Viability of the fetus outside the uterus is frequently used as the determining factor in deciding the legality and morality of induced abortion. Whether this is a valid criterion is essentially based on whether one believes that the fetus is human from the moment of conception or that it achieves humanity at some point during physical development. Those who oppose abortion on moral grounds believe that the fetus is human or potentially human and that destruction of the fetal body is tantamount to murder. Many others have equally strong beliefs that abortion is a woman's right.
The liberalization of abortion laws has resulted in a dramatic increase in the number of abortions performed in physicians' offices, clinics, and hospitals. While this has diminished the occurrence of septic abortions performed at the hands of unscrupulous abortionists and has improved the possibility of safe and uneventful physical recovery from an induced abortion, the issue remains controversial and charged with emotion. The health care provider who strongly objects to abortion is legally and morally free to choose not to participate in the procedure and is advised to avoid situations involving responsibility for the care of patients who have chosen abortion as a means of ending an unwanted pregnancy. Women who have made a decision to have an abortion need a safe, non-judgmental environment to recover physically and emotionally from the procedure.
The patient should know that other alternatives are available and that an abortion after 20 weeks is inadvisable for medical and other reasons. Preabortion counseling in the psychological, religious, and legal aspects of abortion should be readily available, with immediate referral to the proper resources. Although delay in carrying out the procedure may increase the risk of complications, no patient should be encouraged to go through with an abortion until she has had time and sufficient counseling to reach a rational decision. During postabortion counseling there should be a discussion of various methods of contraception
. The client will need information on the advantages and disadvantages of each method, her responsibilities in preventing future unwanted pregnancies, and available help in initiating and following through on a program of effective contraception. She should be informed that women who have had two or more abortions run a greatly increased risk of miscarriage or spontaneous abortion in the first six months of subsequent pregnancies.
Patient Care. The type of care required and the complications to be avoided in abortion will depend on the stage of pregnancy at the time of termination and whether the abortion is spontaneous, is induced under sterile conditions, or is performed by an unskilled abortionist or the patient herself. Many women who choose to have an abortion are anxious and confused about the physical and psychological outcomes of the procedure. Therefore both pre- and postabortion counseling are recommended.
In cases of spontaneous or habitual abortion, patient care is directed toward emotional support of the patient and acceptance of her feelings of bitterness, grief, guilt, relief, and other emotions associated with the loss of the fetus. The patient should be able to express her feelings in an open, nonjudgmental, and nonthreatening environment.
complete abortion complete expulsion of all the products of conception.
criminal abortion termination of pregnancy by illegal interference, usually undertaken when legal induced abortion is unavailable. The most frequent complications are severe hemorrhage and sepsis, and for those who delay seeking medical attention the mortality rate is high.
early abortion abortion within the first 12 weeks of pregnancy.
elective abortion induced abortion done at the request of the mother for other than therapeutic reasons.
habitual abortion spontaneous abortion
in three or more consecutive pregnancies before the 20th week of gestation.
incomplete abortion abortion in which parts of the products of conception are retained in the uterus.
induced abortion abortion brought on intentionally by medication or instrumentation.
inevitable abortion a condition in which vaginal bleeding has been profuse, membranes usually show gross rupturing, the cervix has become dilated, and abortion is almost certain.
infected abortion abortion associated with infection of the genital tract from retained material, with a febrile reaction.
missed abortion retention of dead products of conception in utero for more than 8 weeks.
septic abortion abortion associated with serious infection of the products of conception and endometrial lining of the uterus, leading to generalized infection; it is usually caused by pathogenic organisms of the bowel or vagina.
spontaneous abortion termination of pregnancy before the fetus is sufficiently developed to survive; called miscarriage by laypersons. In the United States this definition is confined to the termination of pregnancy before 20 weeks' gestation (based upon the date of the first day of the last normal menses). Chromosomal abnormalities cause at least half of spontaneous abortions.
therapeutic abortion abortion induced legally by a qualified physician to safeguard the health of the mother.
threatened abortion a condition in which vaginal bleeding is less than in inevitable abortion, the cervix is not dilated, and abortion may or may not occur; this is the presumed diagnosis when any bloody vaginal discharge or vaginal bleeding occurs in the first half of pregnancy.
premature expulsion from the uterus of the products of conception; termination of pregnancy before the fetus is viable.
complete expulsion of all the products of conception.
abortion within the first third of pregnancy.
epizootic bovine abortion
characterized by serious fetal disease followed by abortion. Endemic in California's coastal range and in the foothill region of the Sierra Nevada, USA. Necropsy findings in the fetus are diagnostic; they include profuse petechiation and severe granulomatous hepatitis. Cause appears to be a novel deltaproteobacterium closely related to members of the order Myxococcales. Transmitted by the tick, Ornithodoros coriaceus. Called also foothill abortion.
spontaneous abortion occurring in three or more successive pregnancies.
abortion in which parts of the products of conception are retained in the uterus.
abortion procured by the veterinarian to eliminate a misalliance, to reduce wastage in animals in a feedlot, to encourage commencement of lactation earlier than would otherwise occur. In cattle manipulation through the rectal wall is a possible way of destroying the viability of the fetus. Induction by the administration of prostaglandins or corticosteroids is more usual. See also pregnancy
the common causes in the various species are:
cattle Brucella abortus
(brucellosis); Campylobacter fetus
(vibriosis); Campylobacter fetus
; Leptospira pomona
, L. hardjo
(leptospirosis); Listeria monocytogenes
(listeriosis); Arcanobacterium pyogenes; Aspergillus
spp. (fungal abortion); bovine virus diarrhea virus; infectious bovine rhinotracheitis herpesvirus; Chlamydophila abortus
; a deltaproteobacterium (epizootic bovine abortion
); Coxiella burnetii
(Q fever), Neospora caninum
sheep and goats Campylobacter fetus
(vibriosis); Campylobacter jejuni; Chlamydophila abortus
abortion of ewes); Listeria monocytogenes
(listeriosis); Salmonella abortus-ovis
; Brucella melitensis; Toxoplasma gondii
(toxoplasmosis); Brucella ovis
(limited occurrence); bluetongue virus; border disease.
Streptococcus equi subsp zooepidemicus; Actinobacillus equuli, A. equisimilis; Rhodococcus equi; leptospirosis, most commonly the pomona serogroup and less frequently serovar grippotyphosa; equine herpesvirus (EHV1); equine viral arteritis (EVA); equine arteritis; Potomac horse fever; and in the USA the mare reproductive loss syndrome associated with ingestion of the Eastern tent caterpillar Malacosoma americanum.
Leptospira pomona, L. grippotyphosa, L. canicola, L. icterohaemorrhagiae (leptospirosis); Erysipelothrix rhusiopathiae (erysipelas); porcine reproductive respiratory syndrome (PRRS) virus; parvovirus; porcine circovirus 2; Aujesky's disease; classical swine fever; and African swine fever.
dog and cat
Brucella canis, feline leukemia virus, feline herpesvirus.
retention of a dead embryo or fetus for more than 1 to 2 weeks.
pine needle abortion
a late-term abortion with retained fetal membranes in cattle caused by ingestion of isocupressic acid in the needles of Pinus spp., commonly P. ponderosa, but also P. jeffryi, P. contorta and Juniperus scopulorum and J. communis. Nutrient deficiency and tree management practices may promote ingestion off the ground as cattle graze through while eating early growing spring grass.
number of abortions as a percentage of the cows in the herd which were diagnosed pregnant in early pregnancy; the target is <2% but rates commonly approach 8% in dairy cattle and 5% in beef cattle.
abortion associated with serious infection of the uterus leading to generalized infection.
abortion occurring naturally. See also spontaneous
a cluster of abortions occurring at about the same time or in rapid sequence within a group of pregnant females. See also equine viral
abortion induced by a veterinarian for medical or other health reasons.
having no apparent external cause.
most animal abortions are spontaneous in contradistinction to the surgically and medically procured abortions of humans. See also mismating
avian spontaneous cardiomyopathy
an idiopathic disease of 1 to 4 week old turkey poults causing sudden death or a brief period of dyspnea; the heart is visibly dilated.
spontaneous internal hemorrhage
causes sudden death in most cases; causes include cardiac tamponade, aortic or atrial rupture, splenic rupture.
spontaneous pulmonary arteriopathy spontaneous regression
when diseases resolve themselves without outside assistance.
spontaneous virus encephalitis
so called because the disease appears without the subject animal coming in contact with a known encephalitogenic agent. In most instances the occurrence is eventually explained by the presence of a hitherto unknown virus.