INCOMPLETE ABORTION

Clinical Features

As shown in Table as for threatened abortion.

Management

  • Resuscitate with fluids (normal saline and dextrose). If the patient is in shock, transfer to higher level for appropriate management.
  • Give oxytocin 10 IU IM or ergometrine 0.5mg IM STAT.
  • Remove POC from cervical os digitally or with ovum forceps.
  • Evacuate the uterus, preferably with manual vacuum aspiration (MVA) as soon as possible under para-cervical nerve block (10ml of 2% lignocaine HCL: 2.5ml injected at 2, 4, 8, and 10 o’clock positions of the cervix). NB: The
    uterus can be evacuated with either MVA or medication.

    • Misoprostrol 300μg orally in a single dose will achieve completion in over 90% of the cases.
    • For pain, IM diclofenac 75mg STAT
  • Give antibiotics: Doxycycline 500mg QDS + metronidazole 400mg TDS for 7 days.

Patient Education

As for complete abortion.