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INCOMPLETE ABORTION
If bleeding is light to moderate and pregnancy is less than
16 weeks
Use fingers or ring (or sponge) forceps to remove products
of conception protruding through the cervix.
If bleeding is heavy and pregnancy is less than 16 weeks
Evacuate the uterus. Manual vacuum aspiration is the preferred
method of evacuation. Evacuation by sharp curettage should only
be done if manual
vacuum aspiration is not available.
If evacuation is not immediately possible, give:
| :: |
Ergometrine
0.2 mg IM, repeated after 15 minutes if necessary |
| :: |
Or |
| :: |
Misoprostol
400 mcg orally (repeated once after 4 hours if necessary). |
If
pregnancy is greater than 16 weeks
| 1 |
Infuse
oxytocin 40 units in 1 L IV fluids (normal saline or
Ringer’s lactate)
at 40 drops per minute until expulsion of products of conception occurs. |
| 2 |
If
necessary, give misoprostol 200 mcg vaginally every 4
hours until
expulsion, but do not administer more than 800 mcg. |
| 3 |
Evacuate
any remaining products of conception fr om the uterus. |
| 4 |
Ensure
follow-up of the woman after treatment (see below). |
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