It is one of the commonest complications of the first trimester of pregnancy.

What is the difference between miscarriage and abortion?

No difference. They are synonymous terms. Some people think that the term “abortion” means an induced intentional event, it is not so. Abortion can either be spontaneous or induced.

What is the definition of  abortion?

U.K Legal definition: Termination of pregnancy before 24 weeks of gestation with no evidence of life.

W.H.O 1977 definition: Miscarriage is the extraction or expulsion of a fetus (embryo) weighing less than 500g equivalent to approximately 20 to 22 weeks of gestation(age of viability).

Please note that in developing countries the age of  viability is 26 to 28 weeks, because of the lack of facilities.

What is the incidence of miscarriages?

Miscarriage affects approximately 15 % of clinically apparent pregnancies. About 25% of women will have one or more miscarriages in their lifetime.

What is the incidence of legal abortion ?

In the UK approximately 190,000 abortions are carried out every year .

It is around 9-14 per 1000 women aged 15-45 years.

The lifetime chance of a legal abortion is 1 in 40 women.

What are the main classes of abortion?

Abortion can be categorized in different ways. Some of the commonly used categories include:

i)      Legal or illegal.

ii)     Induced or Spontaneous.

iii)    Recurrent or Non- recurrent.

What are the various types of abortion?

a)      Threatened  abortion : This is defined as bleeding (Painless) from the uterus prior to 24 weeks with an un-dilated cervix. The fetus is alive.

b)      Inevitable  abortion: Bleeding from the uterus prior to 24 weeks of gestation with pain and dilatation of the cervix.

c)Incomplete abortion: Part of the products of conception have been expelled but there is continued bleeding due to retained tissues.

d) Complete  abortion: The whole conceptus has been expelled.

e) Recurrent (Habitual) abortion: Three or more consecutive miscarriages.

f) Missed abortion : Failure of pregnancy (in utero death of the fetus) is identified before the expulsion of the products of conception.

The various types of abortion is an extensive topic and merits a post on its own. Most of the readers of my blog are pregnant women who not medical staff or students. I do not want  them to feel overwhelmed, therefore I divide most of the extensive and complicated topics into numerous smaller posts.

What are the causes of abortion?

Some of the common causes of miscarriage include:

Fetal Abnormalities

Abnormalities of implantation

Multiple pregnancy

Intrauterine adhesions

Endocrine abnormalities

Uterine abnormalities

Maternal diseases

Infections

Poisons

Immunological diseases

Cervical incompetence/ weakness.

Trauma

The causes of abortion will be elaborated in another post.

What is the abortion act?

Every country has its own abortion act. This act covers the legal aspects of abortion. The abortion act varies from one country to another, eg In the UK abortion act allows for the lawful termination of pregnancy under certain conditions. In Sri Lanka termination of pregnancy is not allowed even for medical reasons.

I believe that termination of pregnancy must be allowed for certain medical reasons, but it must be carried out with strict guidelines. This will help to reduce the rates of illegal abortions

In UK the abortion act was passed in 1967. It allowed the lawful termination of pregnancy under certain conditions:

A woman may have a pregnancy  terminated if two medical practitioners acting in good faith are willing to certify to one or more of the following criteria:

  • The continuance of the pregnancy would involve risk to the life of the pregnant woman  greater than if the pregnancy were terminated.
  • The termination is necessary to prevent grave permanent injury to the physical or mental health of the pregnant woman.
  • The pregnancy has not exceeded its 24th week and that the continuance of the pregnancy would involve  risk, greater than if the pregnancy were terminated, of injury to the physical or mental health of the pregnant woman.
  • The pregnancy has not exceeded its 24th week and that the continuance of the pregnancy would involve risk, greater than if the pregnancy were terminated , of injury to the physical or mental health of any existing child (ren) of the family of the pregnant woman.
  • There is substantial risk that if the child were born it would suffer from such physical or mental abnormalities as to be seriously handicapped.

The form must be signed by both medical practitioners prior to the abortion being performed and posted to the Chief  Medical Officer of the Department of Health, or to the Scottish Office.

If the abortion is undertaken in order to save a woman’s life then only one signature is required.

Any medical practitioner who has an objection to abortion may refer to another practitioner to perform it.

References:

Dewhurst’s Textbook of Obstetrics and Gynaecology for Postgraduates (Sixth Edition)-Edited by Keith Edmonds FRCOG , FRACOG

Oxford Handbook of Clinical Specialties-6 th edition

Gynaecology by Ten Teachers- edited by Stuart Campbell and Ash Monga- 17th edition

No related posts.

 

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