missed abortion

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Related to missed abortion: Blighted ovum


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.
Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, Seventh Edition. © 2003 by Saunders, an imprint of Elsevier, Inc. All rights reserved.

missed a·bor·tion

abortion in which the fetus dies in utero but the product of conception is retained in utero for 2 months or longer.
Farlex Partner Medical Dictionary © Farlex 2012

missed abortion

The retention of a fetus known to be dead for ≥ 4 wks Management Expectant–spontaneous delivery occurs usually by the 6th post-mortem wk. See Abortion.
McGraw-Hill Concise Dictionary of Modern Medicine. © 2002 by The McGraw-Hill Companies, Inc.

miss·ed abor·tion

(mist ă-bōr'shŭn)
Abortion in which the fetus dies but is retained in utero for 2 months or longer.
Medical Dictionary for the Health Professions and Nursing © Farlex 2012

missed abortion

Death of the fetus which remains in the womb (uterus) for weeks or months. The uterus ceases to enlarge and the cervix remains tightly closed. Pregnancy tests may give equivocal results for several weeks after the death of the fetus but ultrasound scans can reveal the condition. The uterus is cleared surgically.
Collins Dictionary of Medicine © Robert M. Youngson 2004, 2005
References in periodicals archive ?
First, we did not evaluate the pathologic materials of patients with missed abortion. Therefore, we could not compare the serum and decidual or fetal CA 125 levels.
(21), patients with a diagnosis of missed abortion at 14-16 weeks of the pregnancy were administered with intracervical osmotic dilator or 200 mg oral mifepristone for cervical preparation 24 hours before surgical intervention.
Pournaras et al., "Angiopoietin-1 and Angiopoietin-2 as serum biomarkers for ectopic pregnancy and missed abortion. A case-control study," Clinica Chimica Acta, vol.
Almost double increase of HLA-DR of missed abortion high risk group patients is likely associated with the increase of the mother and fetus identity under HLA genes what might be a reason for the early termination of pregnancy.
In the present study metformin therapy during pregnancy was associated with significantly lower fetal loss and missed abortions as compared to the control group.
For example, women who have had a missed abortion (embryonic demise or anembryonic gestation) are less likely to complete with expectant management than women with an in complete abortion.
Menakaya et al reported minimal side effects with misoprostol in management of missed abortion in second trimester26.
Intravaginal misoprostol for medical evacuation of first trimester missed abortion. Prim Care Update Ob Gyns, 1998; 175-6.
In a missed abortion or an inevitable abortion, the fetus is no longer developing or viable; the former term is used if no bleeding or cramping is occurring, while the latter is used if the women presents with an open cervix and vaginal bleeding.
Expectant management is successful within 2 to 6 weeks without increased complications in 80% to 90% of women with first-trimester incomplete spontaneous abortion and 65% to 75% of women with first-trimester missed abortion or anembryonic gestation (presenting with spotting or bleeding and ultrasound evidence of fetal demise) (SOR: B, based on multiple cohort studies).