Habitual Abortion

Subject: Midwifery I (Theory)

Overview

This is a spontaneous and recurring abortion that occurs three or more times in a row. This could be primary or secondary to the birth of a viable fetus. The causes of frequent abortion are complicated, and more than one factor may be at work in certain cases. There are known specific causes that cause early or late abortion, and they are classified as genetic, infectious, idiopathic, and so on.

Habitual abortion refers to spontaneous abortions that occur on three or more occasions in a row. It's also known as recurrent pregnancy loss. It's a type of infertility.

Incidence

  • It affects 1% of all women who have two or more consecutive pregnancy losses before 20 weeks of gestation.

Timing

  • Two-thirds occur after 12 weeks, with one-third occurring in the first trimester.

Etiology

  1. Genetics- aberrant paternal karyotype, the most prevalent of which is translocation
  2. Idiopathic
  3. Recurrent abortions can be caused by genetic abnormalities in the fetus.
  4. Maternal origin
  5. Maternal disorders and infections such as syphilis, diabetes, hypertension, and so on.
  6. Abnormalities in uterine hormones
  • Immunological causes
  • Retroverted uterus etc.

Symptoms

  1. Cervical dilatation without pain
  2. Bleeding in the cervix
  3. Pregnancy abdominal cramps
  4. Membrane rupture resulting in liquid leakage

Investigation

  1. Making history
  2. Examination of the body
  3. Blood tests such as blood grouping, cross-matching, total blood count, ESR, and Rh-typing are examples of blood tests.
  4. Estimation of hemoglobin
  5. Husband karyotyping
  6. LFT, RFT, TFT VDRL, and TORCH ( Toxoplasma, Rubella, Cytomegalovirus, and herpes simplex)
  7. Hysterosalpingogram
  8. Culture of cervical swabs
  9. Antiphospholipid antibody

During Pregnancy

  1. Routine antenatal test
  2. Glucose tolerance test
  3. Ultrasonography
  4. Hormone assays

Management

  1. Assure their mother.
  2. Monitor and record the general vital signs.
  3. Encourage the use of an ultrasound to detect the viability of a pregnancy.
  4. Make sure you get enough sleep.
  5. Advise the patient to avoid vigorous activity, intercourse, and long-distance travel.
  6. Diets heavy in protein, vitamins, minerals, and iron are recommended.
  7. Specific treatments include temporary, cervical repair, venturi suspension, and others.

References

  • Tuitui R. 2002, A textbook of Midwifery A (Antenatal), 3rd edition, Vidyarthi Pustak Bhnadar (Publisher and Distributor), Bhotahity, Kathmandu
  • SlideShare. https://www.slideshare.net/crisbertc/types-of-abortion
  • Prezi. 17 February 2011. https://prezi.com/7avru5nzs1en/types-of-abortion-management-nurses-perspective/
  • NCBI. 22 June 1930. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC381898/?page=3
  • NYTimes. 14. March 2017. http://www.nytimes.com/health/guides/disease/abortion-threatened/overview.html
Things to remember
  • Habitual abortion refers to spontaneous abortions that occur on three or more occasions in a row.
  • 2 or more consecutive pregnancy losses before the 20th week of pregnancy
  • Advise the patient to avoid vigorous activity, intercourse, and long-distance travel.
  • Specific treatments include temporary, cervical repair, ventrio suspension, and others.
Questions and Answers

Abortion that occurs spontaneously on three or more occasions in a row is referred to as habitual abortion. It is additionally known as repeated pregnancy loss. This kind of infertility exists.

Habitual Abortion

Abortion that occurs spontaneously on three or more occasions in a row is referred to as habitual abortion. It is additionally known as repeated pregnancy loss. This kind of infertility exists.

Incidence

  • It affects 1% of all women
  • 2 or more consecutive pregnancy loss before 20 weeks of gestation.

Timing

  • Two third occurring beyond 12 weeks and one-third in early pregnancy.

Etiology

  • Genetics: abnormal parental karyotype of which the most common in translocation
  • Idiopathic
  • Fetal cause: chromosomal defects in the fetus may result in recurrent abortions
  • Maternal cause:
    • Maternal disorder and infection like syphilis, DM, hypertension etc.
    • Hormone
  • Uterus abnormalities.
    • Immunological causes.
    • Retro-verted uterus etc.

Symptoms

  • Painless dilatation of cervix
  • Vaginal bleeding
  • Abdominal cramp during pregnancy
  • Rupture of membrane with leakage of liquor

Investigation

  • History taking,
  • Physical examination,
  • Blood test like blood grouping, cross match, complete blood count, ESR, Rh- typing,
  • Hemoglobin estimation,
  • Karyotyping for husband,
  • LFT, RFT ,TFT,
  • VDRL, TORCH ( Toxoplasma, Rubella, Cytomegalovirus, and herpes simplex),
  • Hysterosalpingogram,
  • Cervical swab culture,
  • Antiphospholipid antibodies,
  • During pregnancy.
    • Routine antenatal test,
    • Glucose tolerance test,
    • Ultrasonography,
    • Hormone assays etc.

Management

  • Confide in the mother.
  • Keep track of and monitor the vital indicators generally.
  • Encourage them to have an ultrasound to see whether they are pregnant.
  • Ensure ample rest in bed.
  • Encourage the patient to stay away from sexual activity, vigorous exertion, and lengthy or extensive travel.
  • Recommendation to take a diet heavy in protein, vitamins, and minerals, as well as iron.
  • Specific treatments, such as ventrio suspension, cervical repair, and temporary

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