You are on page 1of 4

BLEEDING ASSOCIATED WIT FIRST TRIMESTER BLEEDING

I. SPONTANEOUS ABORTION

TYPES OF DEFINITION SIGNS AND VAGINAL UTERINE CERVICAL MANAGEMENT NURSING


ABORTION SYMPTOMS BLEEDING CRAMPING DILATATION INTERVENTIONS
1. Missed Fetus dies in 1) Nausea, Vaginal Slight Closed 1. D&C – Dilatation and 1. Emotional
Abortion utero but not breast spotting Curettage support
expelled; may tenderness (dark- 2. D&E – Dilation and 2. Counseling
expel about 6 2) Cessation of brown); Evacuation
weeks or may pregnancy painless 3. IOL – induction of labor
need D&C appears such as: by a prostaglandin
No increase in suppository or
fundal height misosprostol (Cytotec)
measurement introduced into the cervix
Fetal heart to cause dilation, followed
sounds can no by oxytocin stimulation of
longer be heard administration of
3. Urinary mifepristone to cause
frequency contractions and birth
disappears
4. No prior
clinical
symptoms of
abortion – no
apparent loss of
pregnancy
2. Inevitable Loss of products 1. Rupture of Vaginal Moderate Open 1.ospitalization 1. Instruct
Abortion of conception membranes spotting to severe 2. D&C woman to save
cannot be (moderate 3. D&E all pads and
prevented or to severe) bring them with
halted her.
2. Save any
tissue fragments
passed in the
labor room to
establish all
products of
BLEEDING ASSOCIATED WIT FIRST TRIMESTER BLEEDING
I. SPONTANEOUS ABORTION

conception have
been removed
from the uterus.
3. At home
instruct woman
to record the
number of pads
she uses
because
saturated pad
per hour is an
indication of
severe bleeding.

3. Incomplete Parts of the Subside or Vaginal Severe Open D&C 1. Inform


Abortion products of develop into spotting Suction curettage woman that
conception inevitable (heavy) pregnancy is
(fetus) is abortion already lost and
expelled but the procedure done
membranes or is to protect her
placenta are from
retained in the hemorrhage and
uterus infection and
not to end the
pregnancy.

4. Threatened Possible loss of Backache; fetus Vaginal Slight Closed 1. Hospitalization to assess 1. Avoidance of
Abortion products of not expelled spotting uterine fetal well -being. strenuous
conception (light) cramping 2. UTZ to evaluate viability activity for 24 to
bright red of the fetus. 48 hours to
– 1st sign 3. Blood test for HCG prevent
hormone initially and then bleeding.
after 48 hours, if the 2. Bed rest but
placenta is still intact HCG not CBR is
BLEEDING ASSOCIATED WIT FIRST TRIMESTER BLEEDING
I. SPONTANEOUS ABORTION

in the bloodstream usually not


doubles, if not poor necessary as
placental perfusion this may stop
probably pregnancy will bleeding for
be lost. sometimes but
only pools blood
vaginally and
may reappear
when woman
ambulates.
3. Save all pads.
4. No coitus for
2 weeks after
bleeding
stopped.
5. Sympathetic
understanding
and emotional
support.

5. Complete All products of Vaginal Mild Open 1. No therapy 1. Advise


Abortion conception spotting woman to
(fetus, (light) report heavy
membranes and bleeding.
placenta) are 2. Sympathetic
expelled and emotional
spontaneously support.
without any
assistance

6. Habitual Occurring in 3 or Cerclage 1. Treat the


Abortion more successive cause
pregnancies 2. Emotional
support
BLEEDING ASSOCIATED WIT FIRST TRIMESTER BLEEDING
I. SPONTANEOUS ABORTION

7. Septic Abortion Foul smelling 1. CBC – s. 1. Treat


Abortion complicated by vaginal discharge electrolytes, s. abortion.
infection Uterine cramping creatinine, blood 2. Monitor urine
Fever type and cross- output hourly
match 3. Administer
2. Cervical vaginal medications as
and urine culture ordered
3. Insert indwelling 4. Counseling
Foley catheter
4. IVF
5. Antibiotics:
penicillin,
gentamycin,
clindamycin
6. CVP catheter
7. D&C or D&E
8. Tetanus toxoid SQ
or tetanus
immune globulin
IM as prophylactic
9. Dopamine and
digitalis
10. Oxygen therapy

You might also like