As shown in Table
- As for threatened abortion
- Ultrasound, where available, will confirm foetal death
- Bleeding and clotting time in case disseminated intravascular coagulopathy (DIC) has developed.
- Admit the patient for definitive treatment.
- If more than 12 weeks, induce with the prostaglandin tabs misoprostrol 400μg per vagina. Observe for spontaneous onset of abortion process, then examine for complete abortion; if incomplete do MVA.
- Then if less than 12 weeks, evacuate the uterus with MVA or misoprostrol 800μg orally. Start on antibiotics PO doxycycline 100mg 12 hourly, PO metronidazole 400mg 8 hourly for 5 days, and PO ibuprofen 400mg 8 hourly for 3 days on discharge.
- If complicated with DIC, fresh blood transfusion or fresh frozen plasma is lifesaving.
- As for complete abortion