Treatments for Miscarriage
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Hospital statistics for Miscarriage:
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- 0.34% (43,671) of hospital consultant episodes were for spontaneous abortion in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
- 98% of hospital consultant episodes for spontaneous abortion required hospital admission in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
- 100% of hospital consultant episodes for spontaneous abortion were for women in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
- 77% of hospital consultant episodes for spontaneous abortion required emergency hospital admission in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
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Book Excerpts: Treatment of Miscarriage
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Fever – Recurrent:
Treatment
(In A Page: Pediatric Signs and Symptoms)
-
Repeated viral illnesses
–Reassurance of the parents
–Advice on antipyretics
–Encourage fluid intake
–Limit of sick exposure if possible
-
UTI
–Antibiotics based on bacteria and sensitivity
–Prophylactic antibiotics if underlying cause is present
-
-
-
Bacterial infections: Bacteria-specific antibiotic
-
JRA, Behçet, or IBD
–Prednisone or immunosuppressive medications
-
TRAPS
–Prednisone and etanercept
-
Familial cold urticaria and Muckle-Wells syndrome
–Prednisone may be used
–If amyloidosis is present, colchicine may be required
» READ BOOK EXCERPT ONLINE »
Source: In A Page: Pediatric Signs and Symptoms, 2007
Abortion:
Treatment
(Professional Guide to Diseases (Eighth Edition))
An accurate evaluation of uterine contents is necessary before a plan of treatment can be formulated. The progression of spontaneous abortion can’t be prevented, except possibly in cases caused by an incompetent cervix. The patient must be hospitalized to control severe hemorrhage. If bleeding is severe, a transfusion with packed red blood cells or whole blood is required. Initially, I.V. administration of oxytocin stimulates uterine contractions (if given above 20 weeks’gestation — receptors are absent before this gestational age). If any remnants remain in the uterus, dilatation and curettage or dilatation and evacuation (D & E) should be performed.
D & E is also performed in first- and second-trimester therapeutic abortions. In second-trimester therapeutic abortions, the insertion of a prostaglandin vaginal suppository induces labor and the expulsion of uterine contents. When performed competently, second-trimester D & E is a very safe procedure and allows for termination of pregnancy without the need for a lengthy induction of labor. Early first-trimester abortion may also be accomplished pharmacologically with mifepristone (RU-486) an antiprogestin, followed by a dose of a prostaglandin analogue 2 days later, or surgically, using vacuum aspiration.
After an abortion, spontaneous or induced, an Rh-negative female with a negative indirect Coombs’test should receive Rho(D) immune globulin (human) to prevent future Rh isoimmunization.
In a habitual aborter, spontaneous abortion can result from an incompetent cervix (a clinical retrospective diagnosis suggested by a history of previous second-trimester losses accompanied by membrane rupture or painless cervical dilation). Treatment involves surgical reinforcement of the cervix (cerclage) 12 to 24 weeks after the last menstrual period. A few weeks before the estimated delivery date, the sutures are removed, and the patient awaits the onset of labor. An alternative procedure is to leave the sutures in place and to deliver the infant by cesarean birth. Cerclage hasn’t been shown to be more effective than bed rest.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Low birth weight:
Emergency Interventions
(Professional Guide to Signs & Symptoms (Fifth Edition))
Because low birth weight may be associated with poorly developed body systems, particularly the respiratory system, your priority is to monitor the neonate’s respiratory status. Be alert for signs of distress, such as apnea, grunting respirations, intercostal or xiphoid retractions, or a respiratory rate exceeding 60 breaths/minute after the first hour of life. If you detect any of these signs, prepare to provide respiratory support. Endotracheal intubation or supplemental oxygen with an oxygen hood may be needed.
Monitor the neonate’s axillary temperature. Decreased fat reserves may keep him from maintaining normal body temperature, and a drop below 97.8° F (36.5° C) exacerbates respiratory distress by increasing oxygen consumption. To maintain normal body temperature, use an overbed warmer or an Isolette. (If these are unavailable, use a wrapped rubber bottle filled with warm water, but be careful to avoid hyperthermia.) Cover neonate’s head to prevent heat loss.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Abortion:
Treatment
(Handbook of Diseases)
An accurate evaluation of uterine contents is necessary before a plan of treatment can be formulated. The progression of spontaneous abortion can’t be prevented. If bleeding is severe, a transfusion with packed red blood cells or whole blood is required. Initially, I.V. administration of oxytocin stimulates uterine contractions. If any remnants remain in the uterus, dilatation and curettage or dilatation and evacuation should be performed.
Dilation and evacuation is also performed in first- and second-trimester therapeutic abortions. Medical abortion, using mifepristone (RU-486) and misoprostol (a prostaglandin) is also effective (90% to 97%) for pregnancy termination less than 49 days from the last menses.
After an abortion, spontaneous or induced, an Rh-negative female with a normal indirect Coombs’test result should receive Rho(D) immune globulin (human) to prevent further Rh isoimmunization.
In a patient who has suffered from habitual abortion, spontaneous abortion can result from an incompetent cervix. Treatment involves bed rest and, in some situations, surgical reinforcement of the cervix 12 to 14 weeks after the last menses. A few weeks before the estimated delivery date, the sutures are removed and the patient awaits the onset of labor. An alternative procedure, especially for a woman who wants to have more children, is to leave the sutures in place and to deliver the infant by cesarean birth.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Low birth weight:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ Initiate feedings as soon as possible and continue to feed the neonate every 2 to 3 hours.
▪ Provide gavage or I.V. nutrition for the sick or very premature neonate.
▪ Check abdominal girth daily or more frequently if indicated, and check stools for blood to detect necrotizing enterocolitis.
▪ Prepare for a sepsis workup if signs of infection are associated with low birth weight.
▪ Check the neonate's vital signs every 15 minutes for the first hour and at least once every hour thereafter until his condition stabilizes.
▪ Be alert for changes in temperature or behavior, feeding problems, respiratory distress, or periods of apnea—possible indications of infection.
▪ Monitor blood glucose levels and watch for signs and symptoms of hypoglycemia, such as irritability, jitteriness, tremors, seizures, irregular respirations, lethargy, and a high-pitched or weak cry.
▪ If the neonate is receiving supplemental oxygen, carefully monitor arterial blood gas values and the oxygen concentration of inspired air to prevent retinopathy.
▪ Monitor the neonate's urine output by weighing diapers before and after voiding.
▪ Check urine color, measure specific gravity, and test for the presence of glucose, blood, or protein.
▪ Watch for changes in the neonate's skin color because increasing jaundice may indicate hyperbilirubinemia.
Patient teaching
▪ Explain disorder and all procedures and treatments to the parents.
▪ Encourage the parents to participate in their neonate's care to strengthen bonding.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
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