Abortion

Up to 20% of pregnancies abort before 20 weeks; there are usually no apparent reasons for abortion. The greater the amount of bleeding, the more likely the female is to develop shock (orthostatic drop in blood pressure; pallor and sweating); shock is a major risk during abortion.

Septic abortion-

HISTORY-Pregnant less than 20 weeks; often a history of trying to induce abortion; fever, chills, and severe pelvic pain. The woman is often unmarried and without parental support.

PHYSICAL EXAM-Fever with abortion; exquisitely tender uterus or adnexae often present. Hypotension, pallor, and sweating are frequently present.

Threatened abortion

HISTORY- Pregnant less than 20 weeks; vaginal bleeding; may have cramps.
PHYSICAL EXAM-Cervix is closed.

Imminent abortion

HISTORY-Pregnant less than 20 weeks; vaginal bleeding; may have cramps.but usually has cramps.
PHYSICAL EXAM-Cervix is dilated

Inevitable abortion

HISTORY-Pregnant less than 20 weeks; vaginal bleeding; may have cramps.
PHYSICAL EXAM-Cervix is dilated; fetal or placental tissue is protruding from cervix.

Incomplete abortion

HISTORY-As above, but may have noted passing of tissue; cramps and bleeding persist.
PHYSICAL EXAM-Cervix is dilated; fetal or placental tissue may be present.

Complete abortion

HISTORY-Pregnant less than 20 weeks; fetal or placental tissue has been passed; cramps and bleeding have ceased.
PHYSICAL EXAM-Somewhat variable, depending on time since abortion. Prompt closing of cervix expected after completed abortion.

Placenta previa or abruptio placentae

HISTORY-Excessive vaginal bleeding during the third trimester.
PHYSICAL EXAM-Hypotension from blood loss may be present; fundus of uterus consistent with third term of pregnancy.

Bloody show

HISTORY-Minimal bleeding and passage of mucus plug prior to delivery; uterine contractions.
PHYSICAL EXAM-Term pregnant uterus

Menstrual cramps

HISTORY-Nonpregnant woman; cramps and bleeding in association with menstrual period.
PHYSICAL EXAM-Normal pelvic exam