eMedicine Specialties > Emergency Medicine > Obstetrics & Gynecology
Abortion, Complications: Differential Diagnoses & Workup
Updated: Dec 12, 2008
- Overview
- Differential Diagnoses & Workup
- Treatment & Medication
- Follow-up
Differential Diagnoses
Other Problems to Be Considered
Perforated viscus
Acute peritonitis
Workup
Laboratory Studies
- Complete blood count, platelets
- Complete metabolic screen
- Beta-human chorionic gonadotropin, quantitative level may provide useful information and a basis for future comparison.
- Prothrombin time/activated partial thromboplastin time
- Urinalysis
- Type and screen or type and cross with antibody screen (with severe hemorrhage)
- Fibrinogen and fibrin split products if DIC is suspected
- D-dimer
Imaging Studies
- To exclude free air as a result of bowel perforation, perform either upright chest x-ray or upright abdominal x-ray.
- Order or perform ultrasound with a vaginal probe to rule out ectopic pregnancy, retained products of conception, and hematometra.
- Order arteriography if injury to large blood vessels is suspected.
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References
Darney PD, ed. Handbook of Office and Ambulatory Gynecologic Surgery. Blackwell Science Inc; 1987:108.
Grimes DA, Cates W Jr. Deaths from paracervical anesthesia used for first-trimester abortion, 1972-1975. N Engl J Med. Dec 16 1976;295(25):1397-9. [Medline].
Grossman D, Blanchard K, Blumenthal P. Complications after second trimester surgical and medical abortion. Reprod Health Matters. May 2008;16(31 Suppl):173-82:[Medline].
Hakim-Elahi E, Tovell HM, Burnhill MS. Complications of first-trimester abortion: a report of 170,000 cases. Obstet Gynecol. Jul 1990;76(1):129-35. [Medline].
Lohr PA. Surgical abortion in the second trimester. Reprod Health Matters. May 2008;16(31 Suppl):151-61:[Medline].
Sam C, Hamid MA, Swan N. Pyometra associated with retained products of conception. Obstet Gynecol. May 1999;93(5 Pt 2):840. [Medline].
Shannon C, Brothers LP, Philip NM, Winikoff B. Infection after medical abortion: a review of the literature. Contraception. Sep 2004;70(3):183-90. [Medline].
Shulman SG, Bell CL, Hampf FE. Uterine perforation and small bowel incarceration: sonographic and surgical findings. Emerg Radiol. Aug 16 2006;[Medline].
Stuart GS, Sheffield JS, Hill JB, et al. Morbidity that is associated with curettage for the management of spontaneous and induced abortion in women who are infected with HIV. Am J Obstet Gynecol. Sep 2004;191(3):993-7. [Medline].
Stubblefield PG. First and second trimester abortion. In: Nichols DH, ed. Gynecologic and Obstetric Surgery. Mosby-Year Book; 1993:1016-1030.
Stubblefield PG. Pregnancy termination. In: Obstetrics: Normal and Problem Pregnancies. 3rd ed. Churchill Livingstone; 1996:1249-1276.
Stubblefield PG, Grimes DA. Septic abortion. N Engl J Med. Aug 4 1994;331(5):310-4. [Medline].
Further Reading
Keywords
miscarriage, abortion complications, spontaneous abortion, therapeutic abortion, postabortion complications, complications of anesthesia, postabortion triad, vaginal bleeding, hematometra, retained products of conception, uterine perforation, bowel and bladder injury, failed abortion, septic abortion, cervical shock, cervical laceration, disseminated intravascular coagulation, DIC, complications of abortion
Differential Diagnoses & Workup: Abortion, Complications