SAMAR STATE UNIVERSITY
COLLEGE OF NURSING AND HEALTH SCIENCES
Submitted to:
MRS. MARY ANNE D. APACIBLE
Submitted by:
VENICE MARIE G. DACALLOS
LORELYN FABRIGARAS
(BSN 3B – GROUP E)
OCTOBER 2023
I.
Introduction
An incomplete abortion is a medical condition that occurs when a pregnancy is not fully terminated or
expelled from the uterus and are lost in the first 20 weeks of pregnancy. Moderate to severe vaginal
bleeding, as well as lower abdomen and/or pelvic pain, are common symptoms of incomplete abortion .
It can be a potentially serious and distressing situation for pregnant woman who experience it. This
condition can occur spontaneously, as a result of a miscarriage, or it may occur after an elective abortion
procedure.
Incomplete abortions can pose health risks, including the potential for infection, excessive bleeding, and
emotional distress. Therefore, prompt medical attention and intervention are typically required to manage
and resolve the situation.
This condition underscores the importance of safe and appropriate abortion care, as well as the need for
access to healthcare services for women facing unintended pregnancies.
Riza Tomagara, a 17-year-old patient, with 10 weeks pregnant, was experiencing vaginal bleeding with
expulsion of blood clots and has been referred from Gandara District Hospital to Samar Provincial
Hospital for further obstetric evaluation. She was admitted on October 3, 2023 at 9:44 pm.
Based on the patient’s laboratory results, her RBC, hemoglobin, and hematocrit had low count. And her
sonographic report findings are compatible with incomplete abortion .
II. Patient’s History
Past History
Gravida 1, Para 0
Present History
1 day PTA; patient started having vaginal bleeding, mild to moderate in amount
with blood clots; persistence of ssx prompted admission.
Internal Examination showed 2-3 cm, (+) blood stain on exam finger.
II.
Pathophysiology
Incomplete abortion occurs when there is a failure to completely expel all fetal and placental tissue from
the uterus following an abortion or miscarriage. The pathophysiology of incomplete abortion involves
various factors and processes:
1. Inadequate Uterine Contractions: Adequate uterine contractions are crucial for the
expulsion of fetal and placental tissue. Insufficient contractions can result in incomplete
abortion as the uterus fails to effectively expel all the products of conception.
2. Cervical Incompetence: The cervix plays a vital role in maintaining the integrity of the
uterus during pregnancy. If the cervix is weak or incompetent, it may not remain closed
as needed, leading to incomplete abortion. The open cervix allows for the passage of
some fetal or placental tissue, while some remains inside the uterus.
3.
Retained Placental Tissue: The placenta is responsible for providing nutrients and
oxygen to the developing fetus. Incomplete abortion can occur if the placental tissue is
not fully expelled. Retained placental tissue can cause persistent bleeding and prevent
the uterus from contracting effectively.
4.
Uterine Anomalies: Certain structural abnormalities of the uterus can contribute to
incomplete abortion. Conditions such as uterine fibroids, septate uterus, or other
congenital anomalies can impair the uterus's ability to contract and expel fetal and
placental tissue completely.
5. Hormonal Imbalances: Hormonal imbalances, particularly involving the hormones that
regulate uterine contractions and the shedding of the uterine lining, can disrupt the
normal process of abortion. Insufficient levels of progesterone or abnormalities in other
hormonal pathways can lead to ineffective uterine contractions and incomplete abortion.
The retained fetal and placental tissue can cause symptoms such as prolonged or heavy bleeding,
cramping, pelvic pain, and sometimes, signs of infection. In cases of incomplete abortion, medical
intervention may be required to remove the remaining tissue and prevent complications such as infection
or excessive bleeding.
III.
3 Problems Identified According to the Patient’s Diagnosis (Apply Prioritization)
 Risk for Excessive Bleeding related to Retained Placental Tissue
 Risk for Infection related to Retained Products of Conception
 Deficient Knowledge related to Incomplete Abortion and Self-care measures