Missed Abortion: Retention of all product of conception after the death of the fetus in the uterus.

Sign and Symptom 1. Absence of Fetal heart tone. 2. Signs of pregnancy disappear. Uterus fails to enlarge Fetal heart sounds are not heard at the appropriate time A serum of urine test for the subunit of HCG becomes negative earlier than expected or does not double within 48-72 hours. UTZ showing no cardiac activity provides the earliest diagnosis. Complication Hemorrhage Infection Malignant

Management 1. Depending on the age of gestation or size of conceptus, the product of conception has tobe removed from the uterus to prevent DIC-(Disseminated intravascular coagulation) a condition resulting from over stimulation of the blood-clotting mechanism in response to disease or injury, such as severe infection, malignancy, acute leukaemia, burns, severe trauma , abruption placenta or intrauterine fetal death. The overstimulation in generalized blood coagulation and excessive consumption factors. The resulting deficiency of these spontaneous bleeding. 2. Up to 28 weeks gestation, it is frequently manage by inserting a 20mg dinoprostone suppository into the vagina q3 or q4 as necessary to produce contraction. 3. Late missed abortion may be completed with a dilute IV infusion of oxytocin, which causes contraction of the uterus and delivery of the product of conception. Nursing Intervention Life style (smoking) Teach to avoid strenuous activity Avoid coitus for one week Teach to notify physician of increasing bleeding Encourage the patient to use peripads, instead of tampons for light vaginal discharged to decrease infection. For pre-conceptual care should be encourage the patient to decide pregnant again.

First Asia Institute of Technology and Humanities College of Nursing

Report In
Batangas Regional Hospital
Submitted by: Ryan Mauie A. Mulano BSN 3-A Submitted to: Maam Rosalie Delizo, RN, MAN