CuraRN

Abortion

Student study notes from paramedic coursework (2023 to 2024), not medical advice. Verify clinical values against current references and your local protocols.

EMS etiologies

Setting: OB/GYN

Abortion is the termination of a pregnancy, which can occur spontaneously or be induced. There are three types of abortion: imminent, spontaneous, and elective. In addition to the medical treatments, emotional support and counseling should be offered.

Imminent Abortion:

Imminent abortion, also known as threatened abortion, is a condition where there is vaginal bleeding in early pregnancy (before 20 weeks’ gestation) without cervical dilation or passage of products of conception. It is often associated with a risk of miscarriage.

Clinical Presentation:

• Vaginal bleeding or spotting (with or without clots)
• Lower back, Abdominal or pelvic pain
• Uterine contractions

  Treatment Modalities:

• Close monitoring of the pregnancy
• Medications to prevent miscarriage (progesterone supplementation for example)

Spontaneous Abortion:

Spontaneous abortion, commonly known as miscarriage, is the loss of a pregnancy before 20 weeks’ gestation. It occurs in approximately 15-20% of pregnancies.

Clinical Presentation:

• Vaginal bleeding or spotting
• Abdominal or pelvic pain
• Passage of tissue or clots
• Disappearance of pregnancy symptoms

Treatment Modalities:

• three treatment modalities can be used
  • Allow the body to expel the tissue naturally
  • Use medications to induce the expulsion of tissue
  • Surgical dilation and curettage or vacuum aspiration

Elective Abortion:

Elective abortion is the deliberate termination of a pregnancy, usually performed in the first or second trimester. It can be induced by medication or surgical intervention.

Clinical Presentation:

The procedure is planned and initiated by the patient

Treatment Modalities:

• Medication abortion (using mifepristone and misoprostol)
• Surgical dilation and curettage or vacuum aspiration