Overview types of abortion

• An abortion process starting before 20 weeks' gestation that has not progressed to a state from which recovery is impossible (potentially reversible)

• Vaginal bleeding

• Fetal activity

• Closed cervical os

• Expectant management

• Avoid strenuous physical activity

• Weekly pelvic ultrasound

• Rule out treatable causes of vaginal bleeding

• Rh(D)-negative women should receive Rh(D)-immune globulin

• A condition of vaginal bleeding and cervical dilation without expulsion of products of conception (POC) that occurs before 20 weeks' gestation.

• Typically followed by partial or complete passage of POC.

• Vaginal bleeding, and visible/palpable products of conception

• Fetal activity may be present.

• Dilated cervical os

• Death of a fetus before 20 weeks' gestation without expulsion of any POC

• No bleeding

• No expulsion of the products of conception

• No fetal activity

• Closed cervical os

• Passage of some but not all POC before 20 weeks' gestation.

• Vaginal bleeding; products of conception within the cervical canal or uterus

• Dilated cervical os

• Usually occurs > 12 weeks' gestation

• Depends mostly on patient preference.

• Expectant management (option for women < 14 weeks gestation)

• Medical evacuation: combination of mifepristone and misoprostol

• Surgical evacuation (D&C): if spontaneous evacuation does not occur after 4 weeks or in cases of septic abortion or heavy bleeding

• The complete passage of all POC before 20 weeks' gestation.

• Vaginal bleeding; products of conception completely outside of the uterus

• Closed cervical os

• Usually occurs < 12 weeks' gestation

No treatment required

• Loss of pregnancy after 20 weeks' gestation (also called intrauterine fetal demise)

• Absence of fetal movements and cardiac activity

• Cervical os variable

• Spontaneous labor usually begins within 2 weeks of intrauterine fetal death.

• Vaginal delivery is safer than cesarean delivery