Unsupervised abortion

actions taken to end a pregnancy without any medical supervision

In 2017, 18% of nonhospital facilities in the US treated women following self-managed abortion.

• Stabilize patients with life-threatening complications, e.g., initiate:

  • Immediate hemodynamic support

  • Sepsis management

  • Management of trauma patients, including FAST

  • Urgent surgical consults (e.g., general surgery, gynecology)

• Pelvic examination to assess for products of conception, injuries, signs of infection (e.g., purulent drainage)

• Obtain diagnostic studies if clinically indicated, e.g.:

  • CBC with differential, type and screen

  • CMP

  • hCG (urine or blood)

  • Cultures: blood, cervical, aspiration of endometrium

• Consider imaging to evaluate for complications.

  • US pelvis: internal bleeding, incomplete abortion, retained products of conception, ectopic pregnancy

  • CT abdomen/pelvis: pelvic abscess, bowel injury, hematoma

• Organ dysfunction (e.g., renal failure, liver damage)

• Uterine perforation or bleeding

• Abdominal or pelvic organ injury

• Infection

• If no complications, provide expectant management with pregnancy test 4 weeks after abortion