Skip to main content

Table 1 The hospital’s guideline for management of abortion

From: Management of abortion complications at a rural hospital in Uganda: a quality assessment by a partially completed criterion-based audit

Initial assessment

Asses for shock and sepsis (fever, foul smelling discharge, hypotension, tachycardia). Give NS, at least 500 ml.

Incomplete abortion

<16 weeks and slight to moderate bleeding: use fingers or ring forceps to remove products protruding through the cervix.

<16 weeks and bleeding is heavy: evacuation by SC. If evacuation is not immediately possible: 0.2 mg ergometrine IM or 400 mcg misoprostol orally.

>16 weeks: 20 IU oxytocin in 1 L IV NS until expulsion of POC.If necessary, give 200 mcg misoprostol vaginally every 4 hour until expulsion, max 800 mcg. Evacuate any remaining POCa

Threatened abortion

Admit and treat with antibiotics. If abdominal pain, give analgesia.

Inevitable abortion

<16 weeks: give 10 IU oxytocin and plan for evacuationa.

>16 weeks, no active bleedingb: await spontaneously expulsion. Control pain. If necessary, infuse oxytocin 20 IU in 1 L IV NS.

Unsafe abortion

Assess for complications, injuries and sepsis. If blood pressure > 100 mmHg give 500 ml NS, if < 100 mmHg 1 L. Give antibiotics. When stable, consider MVA.

  1. A guideline for missed abortion did not exist
  2. IM intramuscular, IU international units, IV intravenous, L litre, mcg micrograms, mg milligrams, ml millilitres, mmHg millimetres of mercury, MVA manual vacuum aspiration, NS normal saline, POC products of conception, SC sharp curettage
  3. aNo recommendation for type of evacuation procedure
  4. bNo recommendations for procedure for inevitable abortion above 16 weeks of gestational age and active bleeding