Monday, April 6, 2009



Many abortions can be prevented by study and treatment of maternal disorders before pregnancy, early obstetric care, with adequate treatment of maternal diabetes, hypertension, etc; and by protection of pregnant women from hazards to health in industry, from exposure to rubella or other infection, trauma , diet deficiencies etc

Picture:On the right side, Cerclage of the cervix [Shirodcar] with incompetent os [hole of cervix] in pregnant woman

On the left side: correction of cervical incompetence in the non-pregnat woman

Prevention of abortion in this writing consist of direct prevention and indirect prevention.
1. Direct prevention is to anticipate potential problems in the period of pregnancy.
2. The indirect prevention is to anticipate better health of mothers and infants in the
period of pregnancy.

The direct prevention is to anticipate potential problems by answer the question:
What are danger signals or general warning signs should the patients be aware of during pregnancy? The patients require to report promptly any sign the following below:
Vaginal bleeding: In the first trimester, bleeding can indicate pending miscarriage [abortion] or ectopic pregnancy. In the second and third trimester, bleeding may indicate placenta previa, placental abruption, or labor.
Abdominal and pelvic pain or cramp may indicate uterus contraction before abortion.
Swelling of face or fingers, severe headache, or blurry vision may indicate hypertension or pre-eclampsia.
Markedly reduced urine output or dysuria, chills, or fever may indicate pyelonephritis [kidney infection] or other infection.
Fluid leaking from the vagina could indicate premature of the membranes.
Decreased fetal movement may indicate fetal compromise.

Plan of action to solve the danger signals or general warning signs:
Vaginal bleeding: If there is the sign of bleeding, administer vitamin K , Phytonadione IM 10 mg/ml, vitamin K 5 mg/tablet per oral 3 times daily, vitamin C 1000 mg /tablet once daily and Adona AC-17 [carbazochrome sodium sulfonate], 10 mg/tablet 3 times daily. Prevention of bleeding for pregnant women administer: vitamin K 5 mg once per week, vitamin C 250 mg once daily, and calcium lactate tablet 500 mg once daily.
Abdominal and pelvic pain or cramp: Administer antispasmodic drugs such as Hyoscyne-N-buthylbromide injection S.C. 20 mg/ml, followed by tablet 10 mg 3 times daily, combine with Papaverine 40mg/tablet 3 times daily.
Swelling of face or fingers, headache and blurry vision and reduce urine output: It need examination of blood pressure, detect edema and laboratory urine examination. If there are hypertension [blood pressure more than 140/90 systole/diastole], edema and protein-uria, these are the sign of pre-eclampsia.

Treatment of hypertension, administer Captopril 25 mg/tablet twice daily or Amlodipine [Norvasc ] 5 mg /tablet once daily.

Treatment edema, administer Chlorothiazide [Diuril] tablet 250 mg twice daily, or Furosemide [Lasix] 40 mg/tablet twice daily.

Prevention of convulsion and coma, administer sedative Phenobarbital 60 mg/tablet oral 3 times daily and anticonvulsant Magnesium sulfate may be given I.V.,20 mg of aqueous solution injected slowly and repeated hourly to prevent or control seizures. Diet with higher protein intake than normal pregnant women.

If there is infection administer antibiotic such as Clindamycin 150-300 mg per oral every 8 hours.
Fluid leaking from vagina could indicate rupture of fetal membrane may be caused by incompetent cervical os [hole] of pregnant women. Treatment with Cervical Cerclage [Shirodkar Operation]. The placement, snug tie, and fixation of a nonabsorbable Mersilene or comparable strand, ribbon or band beneath the mucosa and peri-cervical fascia at the cervico-uterine junction may be done during the pregnant state for correction of cervical incompetence. The physician must then decide whether to release the ligature during labor for vaginal delivery or to perform cesarean section near term.
Decrease fetal movement may indicate fetal compromise. Administer neuromuscular vitamin Neurodex or Neurobion which consists of vitamin B1: 100 mg, B6: 200 mg and B12: 200 microgram, the combination of these vitamins are indicated for polyneuritis, asthenia , paresis, neuralgia , fatigue and treatment of nausea and vomiting during pregnancy.
Vitamin E 100 mg/tablet per oral once daily is indicated for infertility, habitual
abortion, muscle dystrophy, intermittent claudication [cramp of muscle] and pain
in the muscle which limited the contraction or movement of the muscle...

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