Septic System Vaults
septic system electric wiring?
I live in a home that is 20 years old, I recenly discovered that the wiring that goes from my indoor control box and runs undergound to my septic system aerator motor is 14 gauge wiring.
I was thinking that most of these motors were 220 volt to decrease electrical usage over the life of the system but mine is wired 110 volt.
Also…..for a long run out to the back yard is 14 gauge Romex a little under sized?
I do not know the brand specifics but can tell you that my set up has the motor actually inside the cement vault rather than an external blower.
The motor in question, is most likely a ‘low volume’ cfm motor (cfm = cubic feet per minute). These types of motors are designed to run for years, and actually use about the same amount of electricity as a standard 100 watt light bulb, or less.
You can find these motors, also in use in some attic ventilation systems.
I assume, that your wire is in some kind of conduit… “Romex” usually refers to ‘interior’ grade wire…. if you’re going to bury the wire, or use it ‘outside’ then the jacket has to be a different type.
220v is more commonly found on large motors (woodworking equipment, for example), especially those that need a higher amp supply… in these situations, yes, it is often cheaper to operate them on 220v rather than 110v. But for the low amp motors like you’ve mentioned here, its not necessary.
When in doubt, call an electrician 
Good Luck
All American Septic Service, Malibu, CA
Septic System Vaults
Septic System Vaults
abortion
The team of abortions and miscarriages are synonymous and refer to the expulsion of the embryo before it ended before end of week 28 of pregnancy. There was no clear demarcation between late abortions and premature labor beginning the division is not one of convenience rather than descriptive.
After delivery of the fetus at 28 weeks is considered viable. Before the final delivery or 28 weeks, the fetus is notifiable in Great Britain do if born alive, while all deliveries after that date must be notified.
Causes of abortion
Despite a long list of aetiological factors in cases can cause abortions in particular, is uncertain. Known causes are:
1. Malformation the zygote. The most common cause of abortion in particular, is an abnormality in the fetus or the chorion which is insufficient in the server to cause fetal death. About 70 percent of them are caused by chromosomal abnormalities, including two per cent may be liable even if the abortion of this type are not recurrent, so that pregnancy outcomes later is good, except multiple similar pattern of abortion have already taken place.
In some cases, it was found that the dose bag Amniotic fluid does not contain an embryo, a condition once described as a "ruined" egg, but now that pregnancy anembryonic.
- In If all the villi are involved in genetic studies show that the karyotype is 46XX, but everyone Gynecology
the chromosome material is derived from the sperm. triploid mole Partial
karyotype.
2. immune rejection fetus. Many investigations of the immune response from mother to fetus are currently underway. There is some disagreement about the results, but it seems that quotas Some trophoblast cells with maternal antigens. These cross-reactive (TLX) antigens is due in part to other antigens. It is postulated that the mother is mounted an antibody response against antigens TLX, and it protects as the trophoblast against attack by the failure of this mechanism and it also protects the trophoblast from the failure of related antigens. Some causes of recurrent abortion may be caused by the failure of this mechanism and the injection of donor lymphocytes to stimulate the response was proposed.
3. General Disease of the mother. Pregnancy often continue in the spirit of the illness of the mother, but not the disease can cause an abortion if they are sufficiently serious, especially acute fevers. Maternal infection may result in the fetus, all rubella and syphilis, malaria, but rarely, brucellosis toxoplasmosis, cytomegalic inclusion disease and listeriosis.
In some cases of abortion rubella occurs, but more often born alive a fetus infected. The dose for syphilis early abortion, and is a rare cause of abortion later, more likely to cause a stillbirth after 28 weeks.
In diabetes the abortion rate is higher than average, if the disease is not properly controlled.
In cases of hypertension and stillbirth Kidney disease can sometimes occur before week 28.
abortion cause malnutrition server, but it must be a degree that is unlikely to be seen in Britain. Although Vitamin E deficiency cause of abortion in experimental animals there is no evidence that it causes in women because this substance is still present in sufficient quantity in food.
4. abnormalities of the uterus. The incidence of abortion is increased if the uterus is double or septate, but because of pregnancy is much calmer.
The retroversion of the uterus a cause is not a cause of involuntary abortion, except in rare cases where the uterus return to prison and is untreated.
A leiomyoma of the uterus which is closely related to the cavity of the uterus can cause abortion, but will not fibroids.
cervical laceration extending to the interior, you can cause a second trimester abortion or work premature. On very rare occasions the weakness of the cervix is congenital is usually the result of damage or obstetrical bold surgical dilation of the uterus. During pregnancy, the swelling of the membranes unsupported by the neck and break when following a false layer.
5. hormone deficiency. It has been argued that the insufficient production of progesterone by the corpus luteum until the placenta is fully formed lead to the failure of the decidua and abortion.
The evidence is weak (see p. 286).
Prevalence of thyroid deficiency and hyperthyroidism may contribute to causes of abortion.
6. . Cytotoxic Drugs or lead poisoning can cause fetal death and abortion. oxytocic drugs were used to obtain the abortion, quinine, ergot, and prostaglandins are sometimes used as abortifacients, although the dose used may have serious side effects.
7. Trauma. Trauma Server in the uterus can result in the detachment of the embryo, and it can also be caused by the insertion of instruments , or foreign bodies in the neck. Abortion may follow surgery, for example, myomectomy, and can also monitor the conditions complicated by the server peritonitis.
In a normal pregnancy, intercourse does not affect patient, but it is not wise in the case of women with a history abortion of a previous pregnancy.
8. Acute emotional disturbances. As fear or pain may be followed by abortion, probably because of the strong uterine contraction occurs. For this reason, to be admitted in a particular case abortion should follow immediately after the incident.
Pathology
In the first two months of pregnancy the embryo in the decidua is so small that the separation of strong uterine contractions may follow, most often the immediate cause of abortion is a bleeding in the space choriodecidual. The exact cause of bleeding is often unknown, but after the embryo becomes partially or completely separated the decidua.
Gynecology
If the decidua remain close base in the uterus and the embryo of all or part of the decidua capsular type. Sometimes only the caosularis decidua and the embryo is crossed, surrounded by chorionic villi, is expelled, or chorion, and amino acids can be started the fetus, then escapes into the open.
Later, when the placenta is a structure defined, the fetus is usually expelled first, followed by the placenta and membranes, but it is common for the placenta to be kept small, with hemorrhage continues. bacterial invasion detained goods may occur.
Abortion is a work in miniature, the uterus contracts rhythmically, the cervix dilates
and when the internal os is open enough, the embryo is expelled, complete or incomplete. If the embryo is completely expelled, leaving the contraction few days, but finally ceases and the uterus regresses, that the dose after a normal delivery.
In some cases of incomplete abortion is a piece placental tissue may remain in the uterus
because it is fixed at its base. layers of blood clot in the laminate is fixed at its base. A blood clot polypoid mass, and is described as a polyp or placental fibrinoid.
varieties of abortion clinics
The following terms used to describe the clinical varieties:
1. Threatened abortion 5. Septic Abortion
2. inevitable abortion 6. missed abortion (mol fleshy).
3. complete abortion
4. Incomplete Abortion
1. Threatened abortion
In threatened abortion bleeding choriodecidual space but not enough to kill the embryo. There are no painful contractions of the uterus and the cervix does not dilate.
The decision about if abortion is threatened or is only inevitable, it's important but often uncertain. Abortion rates occur at a distance even after repeated attacks on acute hemorrhage, and it is very rare to come across cases where the bleeding continued for a while yet a child born at term health. These cases, however, must always be taken seriously, because at any time of bleeding may occur and abortion becomes inevitable. If the loss continues bright red and increasing the quantity, the prognosis is bleak. A single followed by the loss of brightness to escape the old brown blood loss means that altered ceased publication. It is not uncommon to abortion threatened the loss of so dark go through several days of gradually reducing the quantity.
Administration
The partient remains on bed rest (except for visits to the toilet) until two days after the loss of red color has disappeared. Relations is prohibited. All the pills and all the past should be preserved for review, because it allows diagnosis and avoid a waste of time to conservative treatment products of conception are observed. if the patient is agitated and anxious for a sedative light can be given, but is otherwise worthless.
Different views on the extent to which these patients should be examined. Much women fear that an internal review, the risk of miscarriage, but the examination and the gentle passage of a speculum have the advantage that any cause unexpected bleeding, a cervical polyp or carcinoma can be found, and that any expansion of the cervix was observed.
Once the initial bellding left an ultrasound is performed. This will reveal if the pregnancy is intact. Demonstration of an embryo by the thrust cardiovascular is essential, because even if an embryo is present, we can not conclude on the viability without it. With the activity of a resolution time actual scan area of high mechanical heart can be recognized consistently in 8 weeks. Demonstration of a gestational sac empty after 8 weeks a reliable test is the absence or death of the embryo. The routine examination of patients with threatened abortion showed a frequent cause bleeding during the first trimester of pregnancy Twins surviving twin is good.
If the abortion is complete uterus is indistinguishable from a uterus normal non-pregnant.
When a threat of abortion has been established, the patient should be reassured that the blood did not affect development of the embryo (although obstetrics must then consider the possibility of placental insufficiency in late pregnancy).
2. Abortion inevitable
A threatened abortion is inevitable when bleeding increases significantly and rhythmic uterine contractions become stronger. The cervix begins to dilate, then the products of conception can sometimes be felt through the internal os. Before 12 weeks is common to leave the entire contents of the uterus which is extruded, and the abortion is complete. After week 12 membranes often rupture and the fetus is past, leaving behind the placenta, then all the complications of incomplete abortion may arise.
Diagnosis
inevitable abortion, entoptic pregnancy and cases of hydatidiform mole, all persons present at the triad of pain, vaginal bleeding and amenorrhea. Entoptic pregnancy and abortion are associated with early short period of amenorrhea followed by irregular uterine bleeding. The duration of gestation in pregnant women prior to the entoptic patient pain is usually short, and is almost always less than 10 weeks.
In the abortion bleeding is usually bright red, often accompanied by blood clots and is more abundant during pregnancy and entoptic where bleeding tends to be dark red or brown.
vaginal bleeding during pregnancy entoptic usually preceded by severe abdominal pain, which start low on a lower quadrant, but quickly spread throughout the abdomen. In abortion pain is not as severe and occurs after the onset of bleeding, but that comes and goes like labor pains.
In all cases of ectopic pregnancy, except those with a complete rupture of tubes (in which the diagnosis of intraperitoneal hemorrhage and the shock of generalized abdominal pain is usually evident) there is a tender swelling feeling separated from the uterus is too much, which may be a mole or tubal haematocele. In case of doubt, an ultrasound or laparoscopy may be required.
hydatidiform mole may be the workforce management scale. The uterus is too large, and diagnosis can be confirmed by ultrasound or conclusion high levels of human chorionic gonadotropin material in urine or serum.
Administration
This can be summarized as management work in small scale. The uterus is usually expels its contents alone. Any review should be conducted with aseptic technique. If abortion is not complete quickly, or if bleeding cut, the contents of the uterus are removed with a suction curette. Analgesics such as pethidine
100 mg can be injected, and the bleeding is heavy ergometine 0.5 mg. Unless the patient is known to be Rh positive 100ug must also give anti-D gamma globulin.
3. complete abortion
A complete abortion is one in which all products conception have been expelled. On examination, pain is absent and the bleeding is low and declining. The uterus is smller
then the period amenorrhea suggest, and cervix can be slightly open. If the past material has in store for them, it was found that the entire product of conception is present.
Administration
Once the pain is gone and the bleeding was minimal not need further treatment, but patients should be advised to report immediately if pain or bleeding recurs, or if you develop suggesting that temperatures are kept designing products that have been infected. anti-D globulin is given (as above).
4. Incomplete abortion
This means that some of the products of conception, the fetus in general, it has been But a party, usually the placenta was retained. The amount of bleeding varies, but can be severe and accompanied by a shock dangerous. It is possible for a woman to bleed so badly that in a few hours, the hemoglobin level drops to 5 g / 100 ml. If you follow bleeding one week after an abortion that was designed to be complete is actually incomplete.
Administration
Treatment aims to prevent infection, to control bleeding and get an empty uterus and deflected. The head of the risks associated with stored products are haemorrhage and sepsis, and it is unwise to let a piece of placenta in the uterus for any length of time in the hope that it will be expelled.
If the bleeding is reduced may have an impact. If a patient is transferred to the hospital before the crisis, it can increase to a dangerous extent during travel. These patients require emergency first aid, and a mobile crisis unit to be called to the administration of blood in the house Women Amoul before taking patients to hospital. blood pressure monitors and ergometrine 0.5 mg should be administered once intravenous injection. Even if the uterus is not empty, if the bleeding is often reduced by ergomenrine, although its action in the uterus is less in advance, then at the end of pregnancy. Sometimes bleeding continues because of a large piece of the placenta occurs in the cervical canal, the elimination This under direct vision, using a sterile speculum and sponge forceps, allowing the retraction of the uterus and bleeding uterus. The foot of the bed is raised and morphine 15 mg may be injected. When blood pressure reached normal levels of the patient is transferred to a hospital. They give you anesthesia and the uterus is emptied by the suction curette gloved finger or a sponge forceps. The neck is usually open and is not necessary expansion. Ergometrine 0.5 mg was injected intramuscularly once the uterus is empty. D-globulins Anti is given unless the patient is known to be Rh positive.
In these cases, an incomplete abortion is not associated with hemorrhage severe, but bleeding continued intermittently for weeks and it is due to a fibrinous polyp (p.165). The uterus is still large and the cervix dilates slightly. Surgical evacuation of the uterus is essential. It is sometimes difficult to decide whether a prolonged bleeding after a miscarriage is caused by irregular polyp fibrinous or complete abortion followed by bleeding inactive endometrium, which may occur before the cycle returns to normal. In any case, it is necessary and curettage histology of aspirated material supplementing the diagnosis.
5. Septic Abortion
The uterine cavity can be infected by an abortion, even loved, as a result of an attempt criminal abortion by trying to pass and unitarily instrument in the cervical canal. The patient had suprapubic pain and increased temperature and pulse. There may little bleeding or contraction of the uterus and cervical canal may remain closed. There may be an abdominal rigidity and the uterus is very sensitive the bimanual examination.
In other cases, the infection remains an incomplete abortion, and the symptoms and signs of varying severity.
The most common infectious organisms in Britain today are Staphylococcus aureus, coliform organisms and Clostridium perfringens bactericidal and.
Previously, streptococci, aerobic and anaerobic hemolytic often. The infection most dangerous are those bacteria Gram-negative, which can cause endotrxic around the uterus, causing blood flow to the pelvis or cause sepsis.
Administration
All the cases were admitted to the hospital. When the patient is first seen a speculum and swab used to obtain flow in cervical canal, and a blood test. These are sent immediately to the laboratory for microscopy and culture and to determine the sensitivity organisms to antibiotics. There is much debate about the best option. A combination that can be used is 500 mg of ampicillin 6:00 metronidazole 400 mg by 6 hours orally. When the report is available bacteriological, treatment is considered. It is advisable to continue treatment with antibiotics for at least 5 days after the temperature returns to normal. If septic incomplete abortion treatment will depend in part on the amount of bleeding. If this small, evacuation of the uterus may be deferred for 24 hours to give time to the action of antibiotics, but no piece of tissue in the cervical canal should be removed with forceps sponge flight. However, in many cases, the amount of bleeding is such that the drainage can not be injected intramuscularly 0.5 mg of ergometrine help control bleeding.
In case of septic abortion over 14 weeks of gestation if the fetus died is an infusion of prostaglandins and oxytocin may given in the hope of a spontaneous delivery.
Laparotomy is always an adventure in desperate cases, but it may be indicated if the vaginal cuff has been torn or perforated the uterus. This course may be radiograph shows that the gas under the diaphragm, or if there is evidence of free fluid in the peritoneal cavity after a syringe was used. Bacterial infections, require special mention. dead tissue of the placenta and blood clots are a great way for growth of anaerobic organisms. Some of these patients, usually after a criminal action, fell seriously ill with a pulse of 140 per minute and a temperature below normal. It is a severe anemia due to hemolysis and blood loss, and may be jaundice. When infection is suspected Clostridium soil clinical or biological attacks with massive doses of penicillin are given. All placental tissue death must be removed surgically as soon possible. If no blood transfusion and antibiotics, the possibility that the uterus has become gangrenous must be taken into account. Hysterectomy is shown below. Hyperbaric oxygen therapy is used if available.
In all cases of septic abortion maintains surveillance Careful on the production of urine. The cortical necrosis renal tubular or occasionally can occur.
Another dangerous complication of Septic abortion is a circulatory failure due to vasodilation caused by endotoxins Peripherals released by coliform organisms that have invaded the bloodstream.
About the Author
khurram akhtar
http://urshealth.com
Milan Vault Inc – Milan, MI
Septic System Vaults
Septic System Vaults
abortion
The team of abortions and miscarriages are synonymous and refer to the expulsion of the embryo before it ended before end of week 28 of pregnancy. There was no clear demarcation between late abortions and premature labor beginning the division is not one of convenience rather than descriptive.
After delivery of the fetus at 28 weeks is considered viable. Before the final delivery or 28 weeks, the fetus is notifiable in Great Britain do if born alive, while all deliveries after that date must be notified.
Causes of abortion
Despite a long list of aetiological factors in cases can cause abortions in particular, is uncertain. Known causes are:
1. Malformation the zygote. The most common cause of abortion in particular, is an abnormality in the fetus or the chorion which is insufficient in the server to cause fetal death. About 70 percent of them are caused by chromosomal abnormalities, including two per cent may be liable even if the abortion of this type are not recurrent, so that pregnancy outcomes later is good, except multiple similar pattern of abortion have already taken place.
In some cases, it was found that the dose bag Amniotic fluid does not contain an embryo, a condition once described as a "ruined" egg, but now that pregnancy anembryonic.
- In If all the villi are involved in genetic studies show that the karyotype is 46XX, but everyone Gynecology
the chromosome material is derived from the sperm. triploid mole Partial
karyotype.
2. immune rejection fetus. Many investigations of the immune response from mother to fetus are currently underway. There is some disagreement about the results, but it seems that quotas Some trophoblast cells with maternal antigens. These cross-reactive (TLX) antigens is due in part to other antigens. It is postulated that the mother is mounted an antibody response against antigens TLX, and it protects as the trophoblast against attack by the failure of this mechanism and it also protects the trophoblast from the failure of related antigens. Some causes of recurrent abortion may be caused by the failure of this mechanism and the injection of donor lymphocytes to stimulate the response was proposed.
3. General Disease of the mother. Pregnancy often continue in the spirit of the illness of the mother, but not the disease can cause an abortion if they are sufficiently serious, especially acute fevers. Maternal infection may result in the fetus, all rubella and syphilis, malaria, but rarely, brucellosis toxoplasmosis, cytomegalic inclusion disease and listeriosis.
In some cases of abortion rubella occurs, but more often born alive a fetus infected. The dose for syphilis early abortion, and is a rare cause of abortion later, more likely to cause a stillbirth after 28 weeks.
In diabetes the abortion rate is higher than average, if the disease is not properly controlled.
In cases of hypertension and stillbirth Kidney disease can sometimes occur before week 28.
abortion cause malnutrition server, but it must be a degree that is unlikely to be seen in Britain. Although Vitamin E deficiency cause of abortion in experimental animals there is no evidence that it causes in women because this substance is still present in sufficient quantity in food.
4. abnormalities of the uterus. The incidence of abortion is increased if the uterus is double or septate, but because of pregnancy is much calmer.
The retroversion of the uterus a cause is not a cause of involuntary abortion, except in rare cases where the uterus return to prison and is untreated.
A leiomyoma of the uterus which is closely related to the cavity of the uterus can cause abortion, but will not fibroids.
cervical laceration extending to the interior, you can cause a second trimester abortion or work premature. On very rare occasions the weakness of the cervix is congenital is usually the result of damage or obstetrical bold surgical dilation of the uterus. During pregnancy, the swelling of the membranes unsupported by the neck and break when following a false layer.
5. hormone deficiency. It has been argued that the insufficient production of progesterone by the corpus luteum until the placenta is fully formed lead to the failure of the decidua and abortion.
The evidence is weak (see p. 286).
Prevalence of thyroid deficiency and hyperthyroidism may contribute to causes of abortion.
6. . Cytotoxic Drugs or lead poisoning can cause fetal death and abortion. oxytocic drugs were used to obtain the abortion, quinine, ergot, and prostaglandins are sometimes used as abortifacients, although the dose used may have serious side effects.
7. Trauma. Trauma Server in the uterus can result in the detachment of the embryo, and it can also be caused by the insertion of instruments , or foreign bodies in the neck. Abortion may follow surgery, for example, myomectomy, and can also monitor the conditions complicated by the server peritonitis.
In a normal pregnancy, intercourse does not affect patient, but it is not wise in the case of women with a history abortion of a previous pregnancy.
8. Acute emotional disturbances. As fear or pain may be followed by abortion, probably because of the strong uterine contraction occurs. For this reason, to be admitted in a particular case abortion should follow immediately after the incident.
Pathology
In the first two months of pregnancy the embryo in the decidua is so small that the separation of strong uterine contractions may follow, most often the immediate cause of abortion is a bleeding in the space choriodecidual. The exact cause of bleeding is often unknown, but after the embryo becomes partially or completely separated the decidua.
Gynecology
If the decidua remain close base in the uterus and the embryo of all or part of the decidua capsular type. Sometimes only the caosularis decidua and the embryo is crossed, surrounded by chorionic villi, is expelled, or chorion, and amino acids can be started the fetus, then escapes into the open.
Later, when the placenta is a structure defined, the fetus is usually expelled first, followed by the placenta and membranes, but it is common for the placenta to be kept small, with hemorrhage continues. bacterial invasion detained goods may occur.
Abortion is a work in miniature, the uterus contracts rhythmically, the cervix dilates
and when the internal os is open enough, the embryo is expelled, complete or incomplete. If the embryo is completely expelled, leaving the contraction few days, but finally ceases and the uterus regresses, that the dose after a normal delivery.
In some cases of incomplete abortion is a piece placental tissue may remain in the uterus
because it is fixed at its base. layers of blood clot in the laminate is fixed at its base. A blood clot polypoid mass, and is described as a polyp or placental fibrinoid.
varieties of abortion clinics
The following terms used to describe the clinical varieties:
1. Threatened abortion 5. Septic Abortion
2. inevitable abortion 6. missed abortion (mol fleshy).
3. complete abortion
4. Incomplete Abortion
1. Threatened abortion
In threatened abortion bleeding choriodecidual space but not enough to kill the embryo. There are no painful contractions of the uterus and the cervix does not dilate.
The decision about if abortion is threatened or is only inevitable, it's important but often uncertain. Abortion rates occur at a distance even after repeated attacks on acute hemorrhage, and it is very rare to come across cases where the bleeding continued for a while yet a child born at term health. These cases, however, must always be taken seriously, because at any time of bleeding may occur and abortion becomes inevitable. If the loss continues bright red and increasing the quantity, the prognosis is bleak. A single followed by the loss of brightness to escape the old brown blood loss means that altered ceased publication. It is not uncommon to abortion threatened the loss of so dark go through several days of gradually reducing the quantity.
Administration
The partient remains on bed rest (except for visits to the toilet) until two days after the loss of red color has disappeared. Relations is prohibited. All the pills and all the past should be preserved for review, because it allows diagnosis and avoid a waste of time to conservative treatment products of conception are observed. if the patient is agitated and anxious for a sedative light can be given, but is otherwise worthless.
Different views on the extent to which these patients should be examined. Much women fear that an internal review, the risk of miscarriage, but the examination and the gentle passage of a speculum have the advantage that any cause unexpected bleeding, a cervical polyp or carcinoma can be found, and that any expansion of the cervix was observed.
Once the initial bellding left an ultrasound is performed. This will reveal if the pregnancy is intact. Demonstration of an embryo by the thrust cardiovascular is essential, because even if an embryo is present, we can not conclude on the viability without it. With the activity of a resolution time actual scan area of high mechanical heart can be recognized consistently in 8 weeks. Demonstration of a gestational sac empty after 8 weeks a reliable test is the absence or death of the embryo. The routine examination of patients with threatened abortion showed a frequent cause bleeding during the first trimester of pregnancy Twins surviving twin is good.
If the abortion is complete uterus is indistinguishable from a uterus normal non-pregnant.
When a threat of abortion has been established, the patient should be reassured that the blood did not affect development of the embryo (although obstetrics must then consider the possibility of placental insufficiency in late pregnancy).
2. Abortion inevitable
A threatened abortion is inevitable when bleeding increases significantly and rhythmic uterine contractions become stronger. The cervix begins to dilate, then the products of conception can sometimes be felt through the internal os. Before 12 weeks is common to leave the entire contents of the uterus which is extruded, and the abortion is complete. After week 12 membranes often rupture and the fetus is past, leaving behind the placenta, then all the complications of incomplete abortion may arise.
Diagnosis
inevitable abortion, entoptic pregnancy and cases of hydatidiform mole, all persons present at the triad of pain, vaginal bleeding and amenorrhea. Entoptic pregnancy and abortion are associated with early short period of amenorrhea followed by irregular uterine bleeding. The duration of gestation in pregnant women prior to the entoptic patient pain is usually short, and is almost always less than 10 weeks.
In the abortion bleeding is usually bright red, often accompanied by blood clots and is more abundant during pregnancy and entoptic where bleeding tends to be dark red or brown.
vaginal bleeding during pregnancy entoptic usually preceded by severe abdominal pain, which start low on a lower quadrant, but quickly spread throughout the abdomen. In abortion pain is not as severe and occurs after the onset of bleeding, but that comes and goes like labor pains.
In all cases of ectopic pregnancy, except those with a complete rupture of tubes (in which the diagnosis of intraperitoneal hemorrhage and the shock of generalized abdominal pain is usually evident) there is a tender swelling feeling separated from the uterus is too much, which may be a mole or tubal haematocele. In case of doubt, an ultrasound or laparoscopy may be required.
hydatidiform mole may be the workforce management scale. The uterus is too large, and diagnosis can be confirmed by ultrasound or conclusion high levels of human chorionic gonadotropin material in urine or serum.
Administration
This can be summarized as management work in small scale. The uterus is usually expels its contents alone. Any review should be conducted with aseptic technique. If abortion is not complete quickly, or if bleeding cut, the contents of the uterus are removed with a suction curette. Analgesics such as pethidine
100 mg can be injected, and the bleeding is heavy ergometine 0.5 mg. Unless the patient is known to be Rh positive 100ug must also give anti-D gamma globulin.
3. complete abortion
A complete abortion is one in which all products conception have been expelled. On examination, pain is absent and the bleeding is low and declining. The uterus is smller
then the period amenorrhea suggest, and cervix can be slightly open. If the past material has in store for them, it was found that the entire product of conception is present.
Administration
Once the pain is gone and the bleeding was minimal not need further treatment, but patients should be advised to report immediately if pain or bleeding recurs, or if you develop suggesting that temperatures are kept designing products that have been infected. anti-D globulin is given (as above).
4. Incomplete abortion
This means that some of the products of conception, the fetus in general, it has been But a party, usually the placenta was retained. The amount of bleeding varies, but can be severe and accompanied by a shock dangerous. It is possible for a woman to bleed so badly that in a few hours, the hemoglobin level drops to 5 g / 100 ml. If you follow bleeding one week after an abortion that was designed to be complete is actually incomplete.
Administration
Treatment aims to prevent infection, to control bleeding and get an empty uterus and deflected. The head of the risks associated with stored products are haemorrhage and sepsis, and it is unwise to let a piece of placenta in the uterus for any length of time in the hope that it will be expelled.
If the bleeding is reduced may have an impact. If a patient is transferred to the hospital before the crisis, it can increase to a dangerous extent during travel. These patients require emergency first aid, and a mobile crisis unit to be called to the administration of blood in the house Women Amoul before taking patients to hospital. blood pressure monitors and ergometrine 0.5 mg should be administered once intravenous injection. Even if the uterus is not empty, if the bleeding is often reduced by ergomenrine, although its action in the uterus is less in advance, then at the end of pregnancy. Sometimes bleeding continues because of a large piece of the placenta occurs in the cervical canal, the elimination This under direct vision, using a sterile speculum and sponge forceps, allowing the retraction of the uterus and bleeding uterus. The foot of the bed is raised and morphine 15 mg may be injected. When blood pressure reached normal levels of the patient is transferred to a hospital. They give you anesthesia and the uterus is emptied by the suction curette gloved finger or a sponge forceps. The neck is usually open and is not necessary expansion. Ergometrine 0.5 mg was injected intramuscularly once the uterus is empty. D-globulins Anti is given unless the patient is known to be Rh positive.
In these cases, an incomplete abortion is not associated with hemorrhage severe, but bleeding continued intermittently for weeks and it is due to a fibrinous polyp (p.165). The uterus is still large and the cervix dilates slightly. Surgical evacuation of the uterus is essential. It is sometimes difficult to decide whether a prolonged bleeding after a miscarriage is caused by irregular polyp fibrinous or complete abortion followed by bleeding inactive endometrium, which may occur before the cycle returns to normal. In any case, it is necessary and curettage histology of aspirated material supplementing the diagnosis.
5. Septic Abortion
The uterine cavity can be infected by an abortion, even loved, as a result of an attempt criminal abortion by trying to pass and unitarily instrument in the cervical canal. The patient had suprapubic pain and increased temperature and pulse. There may little bleeding or contraction of the uterus and cervical canal may remain closed. There may be an abdominal rigidity and the uterus is very sensitive the bimanual examination.
In other cases, the infection remains an incomplete abortion, and the symptoms and signs of varying severity.
The most common infectious organisms in Britain today are Staphylococcus aureus, coliform organisms and Clostridium perfringens bactericidal and.
Previously, streptococci, aerobic and anaerobic hemolytic often. The infection most dangerous are those bacteria Gram-negative, which can cause endotrxic around the uterus, causing blood flow to the pelvis or cause sepsis.
Administration
All the cases were admitted to the hospital. When the patient is first seen a speculum and swab used to obtain flow in cervical canal, and a blood test. These are sent immediately to the laboratory for microscopy and culture and to determine the sensitivity organisms to antibiotics. There is much debate about the best option. A combination that can be used is 500 mg of ampicillin 6:00 metronidazole 400 mg by 6 hours orally. When the report is available bacteriological, treatment is considered. It is advisable to continue treatment with antibiotics for at least 5 days after the temperature returns to normal. If septic incomplete abortion treatment will depend in part on the amount of bleeding. If this small, evacuation of the uterus may be deferred for 24 hours to give time to the action of antibiotics, but no piece of tissue in the cervical canal should be removed with forceps sponge flight. However, in many cases, the amount of bleeding is such that the drainage can not be injected intramuscularly 0.5 mg of ergometrine help control bleeding.
In case of septic abortion over 14 weeks of gestation if the fetus died is an infusion of prostaglandins and oxytocin may given in the hope of a spontaneous delivery.
Laparotomy is always an adventure in desperate cases, but it may be indicated if the vaginal cuff has been torn or perforated the uterus. This course may be radiograph shows that the gas under the diaphragm, or if there is evidence of free fluid in the peritoneal cavity after a syringe was used. Bacterial infections, require special mention. dead tissue of the placenta and blood clots are a great way for growth of anaerobic organisms. Some of these patients, usually after a criminal action, fell seriously ill with a pulse of 140 per minute and a temperature below normal. It is a severe anemia due to hemolysis and blood loss, and may be jaundice. When infection is suspected Clostridium soil clinical or biological attacks with massive doses of penicillin are given. All placental tissue death must be removed surgically as soon possible. If no blood transfusion and antibiotics, the possibility that the uterus has become gangrenous must be taken into account. Hysterectomy is shown below. Hyperbaric oxygen therapy is used if available.
In all cases of septic abortion maintains surveillance Careful on the production of urine. The cortical necrosis renal tubular or occasionally can occur.
Another dangerous complication of Septic abortion is a circulatory failure due to vasodilation caused by endotoxins Peripherals released by coliform organisms that have invaded the bloodstream.
About the Author
khurram akhtar
http://urshealth.com
Milan Vault Inc – Milan, MI
Septic System Vaults
Septic System Vaults
abortion
The team of abortions and miscarriages are synonymous and refer to the expulsion of the embryo before it ended before end of week 28 of pregnancy. There was no clear demarcation between late abortions and premature labor beginning the division is not one of convenience rather than descriptive.
After delivery of the fetus at 28 weeks is considered viable. Before the final delivery or 28 weeks, the fetus is notifiable in Great Britain do if born alive, while all deliveries after that date must be notified.
Causes of abortion
Despite a long list of aetiological factors in cases can cause abortions in particular, is uncertain. Known causes are:
1. Malformation the zygote. The most common cause of abortion in particular, is an abnormality in the fetus or the chorion which is insufficient in the server to cause fetal death. About 70 percent of them are caused by chromosomal abnormalities, including two per cent may be liable even if the abortion of this type are not recurrent, so that pregnancy outcomes later is good, except multiple similar pattern of abortion have already taken place.
In some cases, it was found that the dose bag Amniotic fluid does not contain an embryo, a condition once described as a "ruined" egg, but now that pregnancy anembryonic.
- In If all the villi are involved in genetic studies show that the karyotype is 46XX, but everyone Gynecology
the chromosome material is derived from the sperm. triploid mole Partial
karyotype.
2. immune rejection fetus. Many investigations of the immune response from mother to fetus are currently underway. There is some disagreement about the results, but it seems that quotas Some trophoblast cells with maternal antigens. These cross-reactive (TLX) antigens is due in part to other antigens. It is postulated that the mother is mounted an antibody response against antigens TLX, and it protects as the trophoblast against attack by the failure of this mechanism and it also protects the trophoblast from the failure of related antigens. Some causes of recurrent abortion may be caused by the failure of this mechanism and the injection of donor lymphocytes to stimulate the response was proposed.
3. General Disease of the mother. Pregnancy often continue in the spirit of the illness of the mother, but not the disease can cause an abortion if they are sufficiently serious, especially acute fevers. Maternal infection may result in the fetus, all rubella and syphilis, malaria, but rarely, brucellosis toxoplasmosis, cytomegalic inclusion disease and listeriosis.
In some cases of abortion rubella occurs, but more often born alive a fetus infected. The dose for syphilis early abortion, and is a rare cause of abortion later, more likely to cause a stillbirth after 28 weeks.
In diabetes the abortion rate is higher than average, if the disease is not properly controlled.
In cases of hypertension and stillbirth Kidney disease can sometimes occur before week 28.
abortion cause malnutrition server, but it must be a degree that is unlikely to be seen in Britain. Although Vitamin E deficiency cause of abortion in experimental animals there is no evidence that it causes in women because this substance is still present in sufficient quantity in food.
4. abnormalities of the uterus. The incidence of abortion is increased if the uterus is double or septate, but because of pregnancy is much calmer.
The retroversion of the uterus a cause is not a cause of involuntary abortion, except in rare cases where the uterus return to prison and is untreated.
A leiomyoma of the uterus which is closely related to the cavity of the uterus can cause abortion, but will not fibroids.
cervical laceration extending to the interior, you can cause a second trimester abortion or work premature. On very rare occasions the weakness of the cervix is congenital is usually the result of damage or obstetrical bold surgical dilation of the uterus. During pregnancy, the swelling of the membranes unsupported by the neck and break when following a false layer.
5. hormone deficiency. It has been argued that the insufficient production of progesterone by the corpus luteum until the placenta is fully formed lead to the failure of the decidua and abortion.
The evidence is weak (see p. 286).
Prevalence of thyroid deficiency and hyperthyroidism may contribute to causes of abortion.
6. . Cytotoxic Drugs or lead poisoning can cause fetal death and abortion. oxytocic drugs were used to obtain the abortion, quinine, ergot, and prostaglandins are sometimes used as abortifacients, although the dose used may have serious side effects.
7. Trauma. Trauma Server in the uterus can result in the detachment of the embryo, and it can also be caused by the insertion of instruments , or foreign bodies in the neck. Abortion may follow surgery, for example, myomectomy, and can also monitor the conditions complicated by the server peritonitis.
In a normal pregnancy, intercourse does not affect patient, but it is not wise in the case of women with a history abortion of a previous pregnancy.
8. Acute emotional disturbances. As fear or pain may be followed by abortion, probably because of the strong uterine contraction occurs. For this reason, to be admitted in a particular case abortion should follow immediately after the incident.
Pathology
In the first two months of pregnancy the embryo in the decidua is so small that the separation of strong uterine contractions may follow, most often the immediate cause of abortion is a bleeding in the space choriodecidual. The exact cause of bleeding is often unknown, but after the embryo becomes partially or completely separated the decidua.
Gynecology
If the decidua remain close base in the uterus and the embryo of all or part of the decidua capsular type. Sometimes only the caosularis decidua and the embryo is crossed, surrounded by chorionic villi, is expelled, or chorion, and amino acids can be started the fetus, then escapes into the open.
Later, when the placenta is a structure defined, the fetus is usually expelled first, followed by the placenta and membranes, but it is common for the placenta to be kept small, with hemorrhage continues. bacterial invasion detained goods may occur.
Abortion is a work in miniature, the uterus contracts rhythmically, the cervix dilates
and when the internal os is open enough, the embryo is expelled, complete or incomplete. If the embryo is completely expelled, leaving the contraction few days, but finally ceases and the uterus regresses, that the dose after a normal delivery.
In some cases of incomplete abortion is a piece placental tissue may remain in the uterus
because it is fixed at its base. layers of blood clot in the laminate is fixed at its base. A blood clot polypoid mass, and is described as a polyp or placental fibrinoid.
varieties of abortion clinics
The following terms used to describe the clinical varieties:
1. Threatened abortion 5. Septic Abortion
2. inevitable abortion 6. missed abortion (mol fleshy).
3. complete abortion
4. Incomplete Abortion
1. Threatened abortion
In threatened abortion bleeding choriodecidual space but not enough to kill the embryo. There are no painful contractions of the uterus and the cervix does not dilate.
The decision about if abortion is threatened or is only inevitable, it's important but often uncertain. Abortion rates occur at a distance even after repeated attacks on acute hemorrhage, and it is very rare to come across cases where the bleeding continued for a while yet a child born at term health. These cases, however, must always be taken seriously, because at any time of bleeding may occur and abortion becomes inevitable. If the loss continues bright red and increasing the quantity, the prognosis is bleak. A single followed by the loss of brightness to escape the old brown blood loss means that altered ceased publication. It is not uncommon to abortion threatened the loss of so dark go through several days of gradually reducing the quantity.
Administration
The partient remains on bed rest (except for visits to the toilet) until two days after the loss of red color has disappeared. Relations is prohibited. All the pills and all the past should be preserved for review, because it allows diagnosis and avoid a waste of time to conservative treatment products of conception are observed. if the patient is agitated and anxious for a sedative light can be given, but is otherwise worthless.
Different views on the extent to which these patients should be examined. Much women fear that an internal review, the risk of miscarriage, but the examination and the gentle passage of a speculum have the advantage that any cause unexpected bleeding, a cervical polyp or carcinoma can be found, and that any expansion of the cervix was observed.
Once the initial bellding left an ultrasound is performed. This will reveal if the pregnancy is intact. Demonstration of an embryo by the thrust cardiovascular is essential, because even if an embryo is present, we can not conclude on the viability without it. With the activity of a resolution time actual scan area of high mechanical heart can be recognized consistently in 8 weeks. Demonstration of a gestational sac empty after 8 weeks a reliable test is the absence or death of the embryo. The routine examination of patients with threatened abortion showed a frequent cause bleeding during the first trimester of pregnancy Twins surviving twin is good.
If the abortion is complete uterus is indistinguishable from a uterus normal non-pregnant.
When a threat of abortion has been established, the patient should be reassured that the blood did not affect development of the embryo (although obstetrics must then consider the possibility of placental insufficiency in late pregnancy).
2. Abortion inevitable
A threatened abortion is inevitable when bleeding increases significantly and rhythmic uterine contractions become stronger. The cervix begins to dilate, then the products of conception can sometimes be felt through the internal os. Before 12 weeks is common to leave the entire contents of the uterus which is extruded, and the abortion is complete. After week 12 membranes often rupture and the fetus is past, leaving behind the placenta, then all the complications of incomplete abortion may arise.
Diagnosis
inevitable abortion, entoptic pregnancy and cases of hydatidiform mole, all persons present at the triad of pain, vaginal bleeding and amenorrhea. Entoptic pregnancy and abortion are associated with early short period of amenorrhea followed by irregular uterine bleeding. The duration of gestation in pregnant women prior to the entoptic patient pain is usually short, and is almost always less than 10 weeks.
In the abortion bleeding is usually bright red, often accompanied by blood clots and is more abundant during pregnancy and entoptic where bleeding tends to be dark red or brown.
vaginal bleeding during pregnancy entoptic usually preceded by severe abdominal pain, which start low on a lower quadrant, but quickly spread throughout the abdomen. In abortion pain is not as severe and occurs after the onset of bleeding, but that comes and goes like labor pains.
In all cases of ectopic pregnancy, except those with a complete rupture of tubes (in which the diagnosis of intraperitoneal hemorrhage and the shock of generalized abdominal pain is usually evident) there is a tender swelling feeling separated from the uterus is too much, which may be a mole or tubal haematocele. In case of doubt, an ultrasound or laparoscopy may be required.
hydatidiform mole may be the workforce management scale. The uterus is too large, and diagnosis can be confirmed by ultrasound or conclusion high levels of human chorionic gonadotropin material in urine or serum.
Administration
This can be summarized as management work in small scale. The uterus is usually expels its contents alone. Any review should be conducted with aseptic technique. If abortion is not complete quickly, or if bleeding cut, the contents of the uterus are removed with a suction curette. Analgesics such as pethidine
100 mg can be injected, and the bleeding is heavy ergometine 0.5 mg. Unless the patient is known to be Rh positive 100ug must also give anti-D gamma globulin.
3. complete abortion
A complete abortion is one in which all products conception have been expelled. On examination, pain is absent and the bleeding is low and declining. The uterus is smller
then the period amenorrhea suggest, and cervix can be slightly open. If the past material has in store for them, it was found that the entire product of conception is present.
Administration
Once the pain is gone and the bleeding was minimal not need further treatment, but patients should be advised to report immediately if pain or bleeding recurs, or if you develop suggesting that temperatures are kept designing products that have been infected. anti-D globulin is given (as above).
4. Incomplete abortion
This means that some of the products of conception, the fetus in general, it has been But a party, usually the placenta was retained. The amount of bleeding varies, but can be severe and accompanied by a shock dangerous. It is possible for a woman to bleed so badly that in a few hours, the hemoglobin level drops to 5 g / 100 ml. If you follow bleeding one week after an abortion that was designed to be complete is actually incomplete.
Administration
Treatment aims to prevent infection, to control bleeding and get an empty uterus and deflected. The head of the risks associated with stored products are haemorrhage and sepsis, and it is unwise to let a piece of placenta in the uterus for any length of time in the hope that it will be expelled.
If the bleeding is reduced may have an impact. If a patient is transferred to the hospital before the crisis, it can increase to a dangerous extent during travel. These patients require emergency first aid, and a mobile crisis unit to be called to the administration of blood in the house Women Amoul before taking patients to hospital. blood pressure monitors and ergometrine 0.5 mg should be administered once intravenous injection. Even if the uterus is not empty, if the bleeding is often reduced by ergomenrine, although its action in the uterus is less in advance, then at the end of pregnancy. Sometimes bleeding continues because of a large piece of the placenta occurs in the cervical canal, the elimination This under direct vision, using a sterile speculum and sponge forceps, allowing the retraction of the uterus and bleeding uterus. The foot of the bed is raised and morphine 15 mg may be injected. When blood pressure reached normal levels of the patient is transferred to a hospital. They give you anesthesia and the uterus is emptied by the suction curette gloved finger or a sponge forceps. The neck is usually open and is not necessary expansion. Ergometrine 0.5 mg was injected intramuscularly once the uterus is empty. D-globulins Anti is given unless the patient is known to be Rh positive.
In these cases, an incomplete abortion is not associated with hemorrhage severe, but bleeding continued intermittently for weeks and it is due to a fibrinous polyp (p.165). The uterus is still large and the cervix dilates slightly. Surgical evacuation of the uterus is essential. It is sometimes difficult to decide whether a prolonged bleeding after a miscarriage is caused by irregular polyp fibrinous or complete abortion followed by bleeding inactive endometrium, which may occur before the cycle returns to normal. In any case, it is necessary and curettage histology of aspirated material supplementing the diagnosis.
5. Septic Abortion
The uterine cavity can be infected by an abortion, even loved, as a result of an attempt criminal abortion by trying to pass and unitarily instrument in the cervical canal. The patient had suprapubic pain and increased temperature and pulse. There may little bleeding or contraction of the uterus and cervical canal may remain closed. There may be an abdominal rigidity and the uterus is very sensitive the bimanual examination.
In other cases, the infection remains an incomplete abortion, and the symptoms and signs of varying severity.
The most common infectious organisms in Britain today are Staphylococcus aureus, coliform organisms and Clostridium perfringens bactericidal and.
Previously, streptococci, aerobic and anaerobic hemolytic often. The infection most dangerous are those bacteria Gram-negative, which can cause endotrxic around the uterus, causing blood flow to the pelvis or cause sepsis.
Administration
All the cases were admitted to the hospital. When the patient is first seen a speculum and swab used to obtain flow in cervical canal, and a blood test. These are sent immediately to the laboratory for microscopy and culture and to determine the sensitivity organisms to antibiotics. There is much debate about the best option. A combination that can be used is 500 mg of ampicillin 6:00 metronidazole 400 mg by 6 hours orally. When the report is available bacteriological, treatment is considered. It is advisable to continue treatment with antibiotics for at least 5 days after the temperature returns to normal. If septic incomplete abortion treatment will depend in part on the amount of bleeding. If this small, evacuation of the uterus may be deferred for 24 hours to give time to the action of antibiotics, but no piece of tissue in the cervical canal should be removed with forceps sponge flight. However, in many cases, the amount of bleeding is such that the drainage can not be injected intramuscularly 0.5 mg of ergometrine help control bleeding.
In case of septic abortion over 14 weeks of gestation if the fetus died is an infusion of prostaglandins and oxytocin may given in the hope of a spontaneous delivery.
Laparotomy is always an adventure in desperate cases, but it may be indicated if the vaginal cuff has been torn or perforated the uterus. This course may be radiograph shows that the gas under the diaphragm, or if there is evidence of free fluid in the peritoneal cavity after a syringe was used. Bacterial infections, require special mention. dead tissue of the placenta and blood clots are a great way for growth of anaerobic organisms. Some of these patients, usually after a criminal action, fell seriously ill with a pulse of 140 per minute and a temperature below normal. It is a severe anemia due to hemolysis and blood loss, and may be jaundice. When infection is suspected Clostridium soil clinical or biological attacks with massive doses of penicillin are given. All placental tissue death must be removed surgically as soon possible. If no blood transfusion and antibiotics, the possibility that the uterus has become gangrenous must be taken into account. Hysterectomy is shown below. Hyperbaric oxygen therapy is used if available.
In all cases of septic abortion maintains surveillance Careful on the production of urine. The cortical necrosis renal tubular or occasionally can occur.
Another dangerous complication of Septic abortion is a circulatory failure due to vasodilation caused by endotoxins Peripherals released by coliform organisms that have invaded the bloodstream.
About the Author
khurram akhtar
http://urshealth.com
Milan Vault Inc – Milan, MI
Septic System Vaults
Septic System Vaults
abortion
The team of abortions and miscarriages are synonymous and refer to the expulsion of the embryo before it ended before end of week 28 of pregnancy. There was no clear demarcation between late abortions and premature labor beginning the division is not one of convenience rather than descriptive.
After delivery of the fetus at 28 weeks is considered viable. Before the final delivery or 28 weeks, the fetus is notifiable in Great Britain do if born alive, while all deliveries after that date must be notified.
Causes of abortion
Despite a long list of aetiological factors in cases can cause abortions in particular, is uncertain. Known causes are:
1. Malformation the zygote. The most common cause of abortion in particular, is an abnormality in the fetus or the chorion which is insufficient in the server to cause fetal death. About 70 percent of them are caused by chromosomal abnormalities, including two per cent may be liable even if the abortion of this type are not recurrent, so that pregnancy outcomes later is good, except multiple similar pattern of abortion have already taken place.
In some cases, it was found that the dose bag Amniotic fluid does not contain an embryo, a condition once described as a "ruined" egg, but now that pregnancy anembryonic.
- In If all the villi are involved in genetic studies show that the karyotype is 46XX, but everyone Gynecology
the chromosome material is derived from the sperm. triploid mole Partial
karyotype.
2. immune rejection fetus. Many investigations of the immune response from mother to fetus are currently underway. There is some disagreement about the results, but it seems that quotas Some trophoblast cells with maternal antigens. These cross-reactive (TLX) antigens is due in part to other antigens. It is postulated that the mother is mounted an antibody response against antigens TLX, and it protects as the trophoblast against attack by the failure of this mechanism and it also protects the trophoblast from the failure of related antigens. Some causes of recurrent abortion may be caused by the failure of this mechanism and the injection of donor lymphocytes to stimulate the response was proposed.
3. General Disease of the mother. Pregnancy often continue in the spirit of the illness of the mother, but not the disease can cause an abortion if they are sufficiently serious, especially acute fevers. Maternal infection may result in the fetus, all rubella and syphilis, malaria, but rarely, brucellosis toxoplasmosis, cytomegalic inclusion disease and listeriosis.
In some cases of abortion rubella occurs, but more often born alive a fetus infected. The dose for syphilis early abortion, and is a rare cause of abortion later, more likely to cause a stillbirth after 28 weeks.
In diabetes the abortion rate is higher than average, if the disease is not properly controlled.
In cases of hypertension and stillbirth Kidney disease can sometimes occur before week 28.
abortion cause malnutrition server, but it must be a degree that is unlikely to be seen in Britain. Although Vitamin E deficiency cause of abortion in experimental animals there is no evidence that it causes in women because this substance is still present in sufficient quantity in food.
4. abnormalities of the uterus. The incidence of abortion is increased if the uterus is double or septate, but because of pregnancy is much calmer.
The retroversion of the uterus a cause is not a cause of involuntary abortion, except in rare cases where the uterus return to prison and is untreated.
A leiomyoma of the uterus which is closely related to the cavity of the uterus can cause abortion, but will not fibroids.
cervical laceration extending to the interior, you can cause a second trimester abortion or work premature. On very rare occasions the weakness of the cervix is congenital is usually the result of damage or obstetrical bold surgical dilation of the uterus. During pregnancy, the swelling of the membranes unsupported by the neck and break when following a false layer.
5. hormone deficiency. It has been argued that the insufficient production of progesterone by the corpus luteum until the placenta is fully formed lead to the failure of the decidua and abortion.
The evidence is weak (see p. 286).
Prevalence of thyroid deficiency and hyperthyroidism may contribute to causes of abortion.
6. . Cytotoxic Drugs or lead poisoning can cause fetal death and abortion. oxytocic drugs were used to obtain the abortion, quinine, ergot, and prostaglandins are sometimes used as abortifacients, although the dose used may have serious side effects.
7. Trauma. Trauma Server in the uterus can result in the detachment of the embryo, and it can also be caused by the insertion of instruments , or foreign bodies in the neck. Abortion may follow surgery, for example, myomectomy, and can also monitor the conditions complicated by the server peritonitis.
In a normal pregnancy, intercourse does not affect patient, but it is not wise in the case of women with a history abortion of a previous pregnancy.
8. Acute emotional disturbances. As fear or pain may be followed by abortion, probably because of the strong uterine contraction occurs. For this reason, to be admitted in a particular case abortion should follow immediately after the incident.
Pathology
In the first two months of pregnancy the embryo in the decidua is so small that the separation of strong uterine contractions may follow, most often the immediate cause of abortion is a bleeding in the space choriodecidual. The exact cause of bleeding is often unknown, but after the embryo becomes partially or completely separated the decidua.
Gynecology
If the decidua remain close base in the uterus and the embryo of all or part of the decidua capsular type. Sometimes only the caosularis decidua and the embryo is crossed, surrounded by chorionic villi, is expelled, or chorion, and amino acids can be started the fetus, then escapes into the open.
Later, when the placenta is a structure defined, the fetus is usually expelled first, followed by the placenta and membranes, but it is common for the placenta to be kept small, with hemorrhage continues. bacterial invasion detained goods may occur.
Abortion is a work in miniature, the uterus contracts rhythmically, the cervix dilates
and when the internal os is open enough, the embryo is expelled, complete or incomplete. If the embryo is completely expelled, leaving the contraction few days, but finally ceases and the uterus regresses, that the dose after a normal delivery.
In some cases of incomplete abortion is a piece placental tissue may remain in the uterus
because it is fixed at its base. layers of blood clot in the laminate is fixed at its base. A blood clot polypoid mass, and is described as a polyp or placental fibrinoid.
varieties of abortion clinics
The following terms used to describe the clinical varieties:
1. Threatened abortion 5. Septic Abortion
2. inevitable abortion 6. missed abortion (mol fleshy).
3. complete abortion
4. Incomplete Abortion
1. Threatened abortion
In threatened abortion bleeding choriodecidual space but not enough to kill the embryo. There are no painful contractions of the uterus and the cervix does not dilate.
The decision about if abortion is threatened or is only inevitable, it's important but often uncertain. Abortion rates occur at a distance even after repeated attacks on acute hemorrhage, and it is very rare to come across cases where the bleeding continued for a while yet a child born at term health. These cases, however, must always be taken seriously, because at any time of bleeding may occur and abortion becomes inevitable. If the loss continues bright red and increasing the quantity, the prognosis is bleak. A single followed by the loss of brightness to escape the old brown blood loss means that altered ceased publication. It is not uncommon to abortion threatened the loss of so dark go through several days of gradually reducing the quantity.
Administration
The partient remains on bed rest (except for visits to the toilet) until two days after the loss of red color has disappeared. Relations is prohibited. All the pills and all the past should be preserved for review, because it allows diagnosis and avoid a waste of time to conservative treatment products of conception are observed. if the patient is agitated and anxious for a sedative light can be given, but is otherwise worthless.
Different views on the extent to which these patients should be examined. Much women fear that an internal review, the risk of miscarriage, but the examination and the gentle passage of a speculum have the advantage that any cause unexpected bleeding, a cervical polyp or carcinoma can be found, and that any expansion of the cervix was observed.
Once the initial bellding left an ultrasound is performed. This will reveal if the pregnancy is intact. Demonstration of an embryo by the thrust cardiovascular is essential, because even if an embryo is present, we can not conclude on the viability without it. With the activity of a resolution time actual scan area of high mechanical heart can be recognized consistently in 8 weeks. Demonstration of a gestational sac empty after 8 weeks a reliable test is the absence or death of the embryo. The routine examination of patients with threatened abortion showed a frequent cause bleeding during the first trimester of pregnancy Twins surviving twin is good.
If the abortion is complete uterus is indistinguishable from a uterus normal non-pregnant.
When a threat of abortion has been established, the patient should be reassured that the blood did not affect development of the embryo (although obstetrics must then consider the possibility of placental insufficiency in late pregnancy).
2. Abortion inevitable
A threatened abortion is inevitable when bleeding increases significantly and rhythmic uterine contractions become stronger. The cervix begins to dilate, then the products of conception can sometimes be felt through the internal os. Before 12 weeks is common to leave the entire contents of the uterus which is extruded, and the abortion is complete. After week 12 membranes often rupture and the fetus is past, leaving behind the placenta, then all the complications of incomplete abortion may arise.
Diagnosis
inevitable abortion, entoptic pregnancy and cases of hydatidiform mole, all persons present at the triad of pain, vaginal bleeding and amenorrhea. Entoptic pregnancy and abortion are associated with early short period of amenorrhea followed by irregular uterine bleeding. The duration of gestation in pregnant women prior to the entoptic patient pain is usually short, and is almost always less than 10 weeks.
In the abortion bleeding is usually bright red, often accompanied by blood clots and is more abundant during pregnancy and entoptic where bleeding tends to be dark red or brown.
vaginal bleeding during pregnancy entoptic usually preceded by severe abdominal pain, which start low on a lower quadrant, but quickly spread throughout the abdomen. In abortion pain is not as severe and occurs after the onset of bleeding, but that comes and goes like labor pains.
In all cases of ectopic pregnancy, except those with a complete rupture of tubes (in which the diagnosis of intraperitoneal hemorrhage and the shock of generalized abdominal pain is usually evident) there is a tender swelling feeling separated from the uterus is too much, which may be a mole or tubal haematocele. In case of doubt, an ultrasound or laparoscopy may be required.
hydatidiform mole may be the workforce management scale. The uterus is too large, and diagnosis can be confirmed by ultrasound or conclusion high levels of human chorionic gonadotropin material in urine or serum.
Administration
This can be summarized as management work in small scale. The uterus is usually expels its contents alone. Any review should be conducted with aseptic technique. If abortion is not complete quickly, or if bleeding cut, the contents of the uterus are removed with a suction curette. Analgesics such as pethidine
100 mg can be injected, and the bleeding is heavy ergometine 0.5 mg. Unless the patient is known to be Rh positive 100ug must also give anti-D gamma globulin.
3. complete abortion
A complete abortion is one in which all products conception have been expelled. On examination, pain is absent and the bleeding is low and declining. The uterus is smller
then the period amenorrhea suggest, and cervix can be slightly open. If the past material has in store for them, it was found that the entire product of conception is present.
Administration
Once the pain is gone and the bleeding was minimal not need further treatment, but patients should be advised to report immediately if pain or bleeding recurs, or if you develop suggesting that temperatures are kept designing products that have been infected. anti-D globulin is given (as above).
4. Incomplete abortion
This means that some of the products of conception, the fetus in general, it has been But a party, usually the placenta was retained. The amount of bleeding varies, but can be severe and accompanied by a shock dangerous. It is possible for a woman to bleed so badly that in a few hours, the hemoglobin level drops to 5 g / 100 ml. If you follow bleeding one week after an abortion that was designed to be complete is actually incomplete.
Administration
Treatment aims to prevent infection, to control bleeding and get an empty uterus and deflected. The head of the risks associated with stored products are haemorrhage and sepsis, and it is unwise to let a piece of placenta in the uterus for any length of time in the hope that it will be expelled.
If the bleeding is reduced may have an impact. If a patient is transferred to the hospital before the crisis, it can increase to a dangerous extent during travel. These patients require emergency first aid, and a mobile crisis unit to be called to the administration of blood in the house Women Amoul before taking patients to hospital. blood pressure monitors and ergometrine 0.5 mg should be administered once intravenous injection. Even if the uterus is not empty, if the bleeding is often reduced by ergomenrine, although its action in the uterus is less in advance, then at the end of pregnancy. Sometimes bleeding continues because of a large piece of the placenta occurs in the cervical canal, the elimination This under direct vision, using a sterile speculum and sponge forceps, allowing the retraction of the uterus and bleeding uterus. The foot of the bed is raised and morphine 15 mg may be injected. When blood pressure reached normal levels of the patient is transferred to a hospital. They give you anesthesia and the uterus is emptied by the suction curette gloved finger or a sponge forceps. The neck is usually open and is not necessary expansion. Ergometrine 0.5 mg was injected intramuscularly once the uterus is empty. D-globulins Anti is given unless the patient is known to be Rh positive.
In these cases, an incomplete abortion is not associated with hemorrhage severe, but bleeding continued intermittently for weeks and it is due to a fibrinous polyp (p.165). The uterus is still large and the cervix dilates slightly. Surgical evacuation of the uterus is essential. It is sometimes difficult to decide whether a prolonged bleeding after a miscarriage is caused by irregular polyp fibrinous or complete abortion followed by bleeding inactive endometrium, which may occur before the cycle returns to normal. In any case, it is necessary and curettage histology of aspirated material supplementing the diagnosis.
5. Septic Abortion
The uterine cavity can be infected by an abortion, even loved, as a result of an attempt criminal abortion by trying to pass and unitarily instrument in the cervical canal. The patient had suprapubic pain and increased temperature and pulse. There may little bleeding or contraction of the uterus and cervical canal may remain closed. There may be an abdominal rigidity and the uterus is very sensitive the bimanual examination.
In other cases, the infection remains an incomplete abortion, and the symptoms and signs of varying severity.
The most common infectious organisms in Britain today are Staphylococcus aureus, coliform organisms and Clostridium perfringens bactericidal and.
Previously, streptococci, aerobic and anaerobic hemolytic often. The infection most dangerous are those bacteria Gram-negative, which can cause endotrxic around the uterus, causing blood flow to the pelvis or cause sepsis.
Administration
All the cases were admitted to the hospital. When the patient is first seen a speculum and swab used to obtain flow in cervical canal, and a blood test. These are sent immediately to the laboratory for microscopy and culture and to determine the sensitivity organisms to antibiotics. There is much debate about the best option. A combination that can be used is 500 mg of ampicillin 6:00 metronidazole 400 mg by 6 hours orally. When the report is available bacteriological, treatment is considered. It is advisable to continue treatment with antibiotics for at least 5 days after the temperature returns to normal. If septic incomplete abortion treatment will depend in part on the amount of bleeding. If this small, evacuation of the uterus may be deferred for 24 hours to give time to the action of antibiotics, but no piece of tissue in the cervical canal should be removed with forceps sponge flight. However, in many cases, the amount of bleeding is such that the drainage can not be injected intramuscularly 0.5 mg of ergometrine help control bleeding.
In case of septic abortion over 14 weeks of gestation if the fetus died is an infusion of prostaglandins and oxytocin may given in the hope of a spontaneous delivery.
Laparotomy is always an adventure in desperate cases, but it may be indicated if the vaginal cuff has been torn or perforated the uterus. This course may be radiograph shows that the gas under the diaphragm, or if there is evidence of free fluid in the peritoneal cavity after a syringe was used. Bacterial infections, require special mention. dead tissue of the placenta and blood clots are a great way for growth of anaerobic organisms. Some of these patients, usually after a criminal action, fell seriously ill with a pulse of 140 per minute and a temperature below normal. It is a severe anemia due to hemolysis and blood loss, and may be jaundice. When infection is suspected Clostridium soil clinical or biological attacks with massive doses of penicillin are given. All placental tissue death must be removed surgically as soon possible. If no blood transfusion and antibiotics, the possibility that the uterus has become gangrenous must be taken into account. Hysterectomy is shown below. Hyperbaric oxygen therapy is used if available.
In all cases of septic abortion maintains surveillance Careful on the production of urine. The cortical necrosis renal tubular or occasionally can occur.
Another dangerous complication of Septic abortion is a circulatory failure due to vasodilation caused by endotoxins Peripherals released by coliform organisms that have invaded the bloodstream.
About the Author
khurram akhtar
http://urshealth.com
Milan Vault Inc – Milan, MI