Inevitable Abortion Treatment - Diagnosis, Procedure & Cost

Inevitable Abortion Treatment In India

What is Inevitable Abortion?

‘Inevitable abortion’ is another term for ‘pregnancy loss’ or ‘miscarriage.’ The term is used to describe a situation where a miscarriage or pregnancy loss cannot be avoided. It refers to the spontaneous loss of a pregnancy before the 20th week of gestation. The condition is often marked by vaginal bleeding, unusual abdominal cramping, and the passing of tissue from the uterus. 

Inevitable abortion indicates that the pregnancy cannot be continued or sustained. Medical intervention is often crucial to manage or treat unavoidable pregnancy loss. It’s essential for individuals experiencing signs of an inevitable abortion to consult a gynecologist promptly for evaluation and appropriate management.

What Causes Inevitable Abortion?

Inevitable abortion causes may include the following:

Chromosomal abnormalities in the fetus – Chromosomal abnormalities in the fetus, such as errors in genes, can lead to inevitable abortion. Chromosomal abnormalities account for almost 50% of inevitable abortions in the first trimester of pregnancy.

Structural abnormalities of the uterus or cervix – Structural abnormalities of the uterus such as uterine septum or cervical incompetence can increase the risk of inevitable abortion. In this condition, the uterus is not capable to support the development of the fetus.

Age – Women over 35 years of age are at a greater risk of inevitable abortions. As a woman ages, the chances of chromosomal abnormalities in eggs increase, Advanced maternal age, typically defined as over 35 years, impacts the viability of the pregnancy.

Trauma or injury to the abdomen – Trauma or injury to the abdomen can lead to detachment of the placenta, uterine rupture, or direct harm to the developing fetus, increasing the risk of inevitable abortion.

Autoimmune disorders or blood clotting disorders – Autoimmune disorders or blood clotting disorders can lead to inevitable abortion by causing abnormalities in the immune response or blood clotting mechanisms. 

Lifestyle factors – Lifestyle factors such as smoking, drug use, excessive alcohol consumption, and poor nutrition can negatively impact fetal development, interfere with placental function, and disrupt hormonal balance, leading to inevitable abortion. 

Signs of Inevitable Abortion

Inevitable abortions mostly occur during the first trimester of pregnancy. Common signs of inevitable abortions may include:

• Vaginal bleeding, ranging from light spotting to heavy bleeding.
• Abdominal cramping or pain in the lower pelvic area, often similar to menstrual cramps.
• Passing blood clots or tissue from the vagina.
• Decrease or loss of pregnancy symptoms, such as breast tenderness or nausea.
• Fluid leakage from the vagina.
• A feeling of fullness or heaviness in the lower abdomen.
• Fluctuation in heartbeat rate.

Treatment Options for Inevitable Abortions

There are primarily three approaches to treating an inevitable abortion:

Expectant Management –  In the simplest terms, this approach means ‘wait and see what happens.’ Expectant management involves waiting for 7-14 days allowing the pregnancy for medical intervention. Almost 50 percent of women resort to an expectant management approach for inevitable abortion.  This method is mostly recommended in the first trimester of pregnancy.

Medications – Medication for inevitable abortion typically includes the use of a misoprostol tablet, which helps to induce uterine contractions and expel the contents of the uterus. Misoprostol, also known as the ‘abortion pill’ is often administered orally or vaginally. The tablet should only be taken under the supervision of a healthcare provider to ensure safety and effectiveness.

Surgery – Surgical treatment for inevitable abortion includes dilation and curettage (D&C) and dilation & evacuation (D&E). In D&C, the cervix is dilated and the fetal tissue are removed from the uterus. D&E or vacuum aspiration is a safe and quick treatment that involves using a small suction tube to gently remove tissue from inside the uterus.

Which is the Best Treatment For Inevitable Abortion?

While multiple approaches exist for managing inevitable abortion, including medications, expectant management, and surgery, surgery is often the most effective option. Medications such as misoprostol can help induce contractions and expel the fetus content from the uterus. However, medications may not always be successful and can lead to prolonged bleeding or incomplete abortion. In that case, surgery might be required to clean the remaining contents of the uterus. Expectant management can prolong physical and emotional distress. In contrast, surgical approaches such as dilation and curettage (D&C) provide a quicker and more reliable resolution by effectively removing the pregnancy tissue. This minimizes the risk of complications and ensures comprehensive management of the condition. Hence, most healthcare providers consider surgery as the best treatment for inevitable abortion, for it provides a prompt solution to patients looking to treat inevitable abortion.

Diagnosis Before Inevitable Abortion Surgery

Your healthcare team might do a variety of tests to diagnose inevitable abortion or miscarriage:

Blood tests – Blood tests are done to check the level of pregnancy hormone, called human chorionic gonadotropin (hCG). A low or falling level of hCG could indicate a pregnancy loss. If the pattern of changes in your hCG level is irregular, your healthcare professional may recommend more blood tests or an ultrasound.                                                                                                                 

Pelvic exam – A pelvic exam is done to check if the lower end of the uterus has begun to open. An open cervix is often an indicator of inevitable abortion.

Ultrasound – The gynecologist, with an ultrasound, checks for the fetal heartbeat and evaluates if the fetus is growing. If the result indicates no growth of the fetus, it most likely is a sign of an inevitable abortion.

Based on the findings of the tests, the healthcare provider analyzes what might have caused the inevitable abortion and determines the best treatment for the same.

Risks and Complications in Inevitable Abortion Surgery

Although complications after inevitable abortion treatment through D&C are not very serious, they are not unheard of. Commonly noted complications include:

• Risk of uterine perforation or injury to surrounding organs during the procedure.
• Incomplete abortion that requires additional treatments or follow-up procedures.
• Excessive bleeding that requires further medical management.
• Infection of the uterus or surrounding tissues.
• Adverse reactions to anesthesia or sedation used during the procedure.
• Potential for scarring of the uterine lining, which could affect future fertility.
• Emotional distress or psychological impact associated with the procedure and pregnancy loss.
• Risk of complications in future pregnancies, including preterm birth or miscarriage.
• Possible need for additional medical treatments or interventions to manage complications or side effects

Is Inevitable Abortion and Incomplete Abortion Same?

No, inevitable abortion and incomplete abortion are not the same. While both are related to pregnancy loss, there is a thin lining of difference between inevitable abortion and incomplete abortion. Inevitable abortion is a situation where the miscarriage or the pregnancy loss cannot be prevented. Inevitable abortion occurs due to factors such as vaginal bleeding and cervical dilation. It is a condition in which the abortion has occurred but the products of conception have not yet been expelled from the uterus.

Incomplete abortion, on the other hand, occurs when some of the products of conception have been expelled from the uterus, but some remain inside. An incomplete abortion involves vaginal bleeding, cramping (contractions), cervical dilatation, and incomplete passage of the products of conception. Patients experiencing incomplete abortion frequently describe the passage of clots or pieces of tissue and report vaginal bleeding.

Cost of Inevitable Abortion Treatment

The cost of medicines for inevitable abortion costs may be anywhere from Rs. 10,000 to Rs. 15,000.

The cost of D&C surgery for inevitable abortion costs may range from Rs. 30,000 to Rs. 45,000.

The cost of the treatment may differ based on multiple factors including:

• The treatment approach
• The experience and expertise of the doctor
• Diagnostic tests and evaluations before the procedure
• The healthcare facility where the treatment is done
• The city or the location where the treatment is done.