Cases Of Incomplete Abortion Research Articles

ULTRASONOGRAPHY

Objective: To find the value of ultrasound in the management of first trimester vaginal bleeding.Material and Methods: All patients reporting with vaginal bleeding in obstetrics and gynaecology Unit-III, NishtarHospital, Multan were included in the study. Non-pregnant patients and patients with vaginal bleeding due to the causeother than conception were excluded. After history, clinical examination and pregnancy test, ultrasonography was donewith abdominal convex probe (3.5 Mhz) and/or vaginal (5 Mhz) probe to every patient. Results: Overall incidence offirst trimester vaginal bleeding was 12.23%. Disparity between clinical and ultrasonic diagnosis was 17.3% in casesof incomplete abortion, 11.6% in cases of inevitable abortion, 9.7% in cases of threatened abortion, 3.8% in cases ofmissed abortion and 1.9% in cases of blighted ovum and 1.9% in cases of molar pregnancy. The confirmation ofdiagnosis after histopathology of surgically obtained specimen revealed least percentage of misdiagnosis on ultrasoundevaluation. While in ectopic pregnancy no disparity found on clinical, ultrasonographic and surgical results, but it wasmisleading as only late cases with ruptured ectopic pregnancy and obvious clinical signs and symptoms were referredto the hospital. Otherwise USG would have shown increased sensitivity and specificity. Conclusion: Study hasconfirmed the superiority of USG scanning over conventional methods in earlier and more precise diagnosis and thusbetter treatment of patients having first trimester vaginal bleeding. It is more accurate, safe, non-invasive and quick indiagnosis and management. It prevents from undue surgical intervention as well as undue delay in surgery whenrequired. Once bleeding has occurred repeat pregnancy test should he ignored and better not done at all. Thus USGshould he an important diagnostic tool in every emergency unit but importance of clinical diagnosis cannot beoverlooked.

Experience With Manual Vacuum Aspiration in Jos, Nigeria

Context: The equipment for manual vacuum aspiration (MVA) has been in use in our institution for more than 10 years and there is need for operations research on its use. Objective: To evaluate the indication for use of the MVA equipment, the complications, and any other problems arising from its use. Method: This is a descriptive study of the cases that were admitted in our facility between January 1992 and December 2002, and had MVA performed on them for various indications. The records from the minor and major operating registers were collated and analyzed for the number, the ages, indications, anaesthetic methods used and any complications arising in patients who had the procedure. Results: There were 307 (21.5%) manual vacuum aspirations among 1,428 gynaecological patients seen during the period. The women on whom the instrument was used were all in their peak reproductive period with a mean of 27.6 years. Incomplete abortion was the indication for manual vacuum aspiration in 85.3% of the cases, missed abortion in 7.8%, and the evacuation of molar pregnancies in 6.2%. Sedation with Pentazocine (30mg) was the mode of pain control in all cases of incomplete abortion (85.3%). All cases of incomplete abortion spent less than 24 hours on admission for evaluation, basic investigation and definitive treatment with the Karman\'s syringe. The procedure was well tolerated by all the patients. There were no recorded major morbidities following the procedure. Conclusion: Manual vacuum aspiration (MVA) with the use of the Karman\'s Syringe has been accepted as the predominant method of treatment of incomplete abortions in our centre. It was found to be simple, safe and costeffective. It has eliminated the admissions of the patients to the ward for more than 24 hours, thereby drastically reducing costs from hospital bed charges. Key Words: Karman\'s Syringe, Manual Vacuum Aspiration (MVA), Abortion. [ Trop J Obstet Gynaecol, 2004;21:100-103]

Methodological Issues in the South African Incomplete Abortion Study

In 1994, a national hospital-based study was undertaken of cases of incomplete abortion presenting to public hospitals in South Africa. Data were collected for all women admitted to a random sample of hospitals with incomplete abortion during a two-week period. The WHO protocol for such studies was used as a basis for developing the methods to describe the epidemiology of incomplete abortion and hospital management of cases. Attempts were made to estimate the proportion of cases that might have been induced. This report focuses on methodological issues arising from the study that have implications for future research. The findings demonstrate that only a small proportion of the women acknowledged having had an induced abortion and that only a few of those who did showed evidence of interference with pregnancy. Clinical opinion of sepsis and the likelihood of induction were found to be highly unreliable. These findings considerably reduce the usefulness of the WHO-protocol method of estimating the likely origin of incomplete abortions. Results presented in terms of three partially overlapping descriptive categories are judged to better reflect the limitations of the data collected.

A time and cost analysis of the management of incomplete abortion with manual vacuum aspiration

OBJECTIVES: Traditionally, management of incomplete abortion involves use of D&C or suction curettage in the operating room. Such management is costly and time-consuming. In order to potentially save time and money, we studied the use of manual vacuum aspiration curettage (MVAC) for the management of this problem. METHODS: Data on hospital charges and times (e.g. waiting time, procedure time) were obtained for all cases of incomplete abortion presenting to hospital between January 1990 and July 1992. Between January 1990 and July 1991, all cases were managed traditionally. After July 1991, all cases were managed using MVAC in either the emergency room or the labor ward. RESULTS: Compared to the use of electrical suction equipment in the operating theatre, MVAC procedures resulted in significant savings in terms of both waiting times and costs. Waiting time was reduced by 52% and procedure time was reduced from a mean of 33 min to 19 min (P < 0.01). Total hospital costs were reduced by 41% (P < 0.01). CONCLUSIONS: Use of manual vacuum aspiration curettage in the management of incomplete abortion can reduce hospital costs and save time for both patients and clinicians.

Traumatic Perforation of the Uterus

SummaryThe clinical features and management of 40 cases of traumatic perforation of the uterus have been reviewed. Of these 40 cases, 20 were emergency admissions.Perforation of the uterus is more common in the diagnostic group than in the incomplete abortion group. However, the incidence is greater in missed and therapeutic abortions than in either of the above groups, although the numbers are much smaller.The curette was more frequently implicated in perforation of the incomplete abortion cases, whereas it was the dilator or the sound that held the major responsibility in the diagnostic group.In 10 of the 20 patients referred to the hospital, the perforation was associated with removal or insertion of a Gräfenberg ring.In this study it has not been possible to follow‐up those patients who have subsequently become pregnant. Although there are reports of patients who have had an uneventful pregnancy after perforation of the uterus (Heineck, 1908, and Rosenfeld, 1954), much will depend on the extent of the initial injury and the nature of its repair.The importance of having an accurate knowledge of the position and size of the uterus prior to instrumentation should be evident from this report. Such information can usually be ascertained clinically, particularly in the anaesthetized patient; additional useful information can be obtained by careful use of the uterine sound.In general, providing that the patient's condition is good and there has been no obvious trauma to intra‐abdominal structures, cases can be observed in a suitable institution where special facilities are available. However, should there be deterioration, or an inadequate response to treatment, immediate laparotomy must be performed, because the risks of treating such a patient conservatively far outweigh those entailed in the performance of laparotomy.

Management of incomplete abortion

1. An analysis of 500 cases of incomplete abortion is presented.2. The method of management at The Queens Hospital Center is discussed.3. We feel that our results indicate that the routine use of oxytocin infusion and the almost general employment of curettage reduces the total hospital stay, blood loss, morbidity, and convalescence time.4. The administration of specific therapeutic antibiotics in adequate doses should be instituted without hesitation.5. The administration of prophylactic antibiotics is strongly questioned.

The Treatment of Incomplete Abortion: An Analysis of the Management of 311 Cases of Incomplete Abortion Treated at the Woman’s Hospital, New York City from September, 1919 to January, 1924

The Treatment of Incomplete Abortion: An Analysis of the Management of 311 Cases of Incomplete Abortion Treated at the Woman’s Hospital, New York City from September, 1919 to January, 1924

Notes on a case of incomplete abortion

Notes on a case of incomplete abortion

Notes on a case of incomplete abortion

Notes on a case of incomplete abortion