Complete abortion

Complete abortion

Abortion is said to be complete when the products of conception are completely expelled.

Clinical presentation

• Minimal or no per vaginal bleeding

• Uterus smaller than dates and often well contracted

• Cervix may or may not be closed

• The patient may be in shock due to severe bleeding

Pharmacological treatment

• Erythromycin (PO) 500 mg every 8 hours for 5 days

OR

• Amoxicillin + clavulanic acid (FDC) (PO) 625 mg every 8 hours for 5 days

AND

• Metronidazole (PO) 400 mg every 8 hours for 5 days

AND

• Ferrous sulfate + folic acid (FDC) (PO) 1 tablet every 24 hours for 4 weeks

Management of patients in shock

• Call for help and mobilize resources

• Apply Airway, Breathing, Circulation and Dehydration (ABCD) principles of resuscitation

• Give compound sodium lactate (IV) or 0.9% sodium chloride (IV), 3 litres or more in the first hour

• Insert an indwelling urethral catheter

• Give ampicillin (IV) 1 g stat and metronidazole (IV) 500 mg stat

• Obtain blood for Hb

Referral

• Resuscitate the patient and refer to hospital with a nurse escort

Management in a hospital

• If the patient is stable, continue management as above

• If the patient is in shock, continue management as above and give blood transfusion if indicated

Patient education

• Provide counselling, education, and family planning services as described for incomplete abortion above.