complete abortion


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abortion

 [ah-bor´shun]
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.

com·plete a·bor·tion

1. the complete expulsion or extraction from its mother of a fetus or embryo;
2. complete expulsion of any other product of gestation. (for example, blighted ovum).

complete abortion

Obstetrics An abortion or miscarriage in which all tissues have been expulsed; an abortion may be completed by curettage to eliminate necrotic decidual tissue in the uterus, which might act as a nidus for infection. See Abortion.
References in periodicals archive ?
Post-hoc Bonferroni-corrected Mann-Whitney U tests of baseline characteristics for the abortion subgroups revealed no significant differences between subgroups for mean age, gestational age, number of pregnancies, and number of previous abortions (p>0.05), although the number of births was significantly higher in the incomplete abortion group than in the complete abortion group (p<0.05).
Three methods can be employed to confirm a complete abortion: (1) sonogram examination documenting an empty uterus (2) finding a 50% decrease per day in serial serum hCG levels and (3) observing the products of conception during the in-office misoprostol visit.11 The use of ultrasound to determine the outcome of medical abortion and possible need for surgical intervention clearly requires knowledge of the ultrasound finding following medical abortion.
Few patients were also seen having retained peaces of fetal skeletal bones, while in 4.22% patients of complete abortion, all the product of conception were aborted with stasis of mild fluid /blood in the uterine canal.
Complete abortion was defined as the expulsion of both without operative interventoin.
Women experiencing a complete abortion require no treatment; they have already successfully passed the pregnancy.
The number of embryos (n=51) present in the winter collections was higher than would be expected if they had been aborted by females having shown evidence of complete abortions (n=7).
Therefore, efforts by states to collect complete abortion data are essential for evaluating the progress of pregnancy-prevention programs for teenagers.
The WHO study reported that subjects for whom the method failed were significantly heavier than those for whom the method resulted in complete abortion. (43) Heavier women also appear to have an earlier onset of bleeding.
[3] Studies have also shown that vaginal administration of misoprostol after pretreatment with mifepristone resulted in higher complete abortion compared to oral dose.
Women are told to "follow-up" with their "healthcare provider" at 7 to 14 days after their initial visit to determine if the bleeding has stopped, a complete abortion has taken place, and they are alright.
Outcome measures were assessed which included success rates in terms of number of complete abortion, emergency admission rates, pain scores through visual analogue scale (0 no pain 10 unbearable pain), level of satisfaction, incidence rates of side - effects, and number of women who would choose outpatient medical management in future.
In 2-3% of cases, providers wrongly classified the woman as having an incomplete abortion or continuing pregnancy (false negative); in 2%, they wrongly assessed the case as a complete abortion (false positive).