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By Marilyn Sommers

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If the abortion occurs later in the gestation, maceration of the fetus occurs; the skull bones collapse, the abdomen distends with blood-stained fluid, and the internal organs degenerate. In addition, if the amniotic fluid is absorbed, the fetus becomes compressed and desiccated. There are five types of SABs, classified according to symptoms (Table 2): threatened, inevitable, incomplete, complete, and missed. A threatened abortion occurs when there is slight bleeding and cramping very early in the pregnancy; about 50% of women in this category abort.

Dead space provides a smaller volume of air so that less CO2 can be expired. Independent For patients who are acutely ill, the priority is to maintain a patent airway, which can be managed through positioning or the use of an oral airway or endotracheal tube. Position patient in a semiFowler position to allow for optimal chest wall expansion, patient comfort, and adequate gas exchange. Aggressive pulmonary hygiene techniques are used to mobilize secretions and increase alveolar ventilation. These measures should include turning, coughing, and deep breathing every 2 hours; postural drainage and percussion every 4 hours; and sitting up in a chair twice per day.

Explain the risks of blood transfusions, and answer any questions about exposure to blood-borne infections. If needed, provide information about any follow-up laboratory procedures that might be required after discharge. Provide the dates and times that the patient is to receive follow-up care with the primary healthcare provider or the trauma clinic. Give the patient a phone number to call with questions or concerns. Provide information on how to manage any drainage systems, colostomy, intravenous therapies, or surgical wounds.

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