An incomplete abortion is a where the products of conception have not been completely lost from the uterus. It is most likely to occur between 8 to 14 weeks gestation when the placenta is not expelled completely and an Evacuation of the Retained Products of Conception - ERPC - is necessary.
In the acute presentation the cervix is dilated, there is continuing haemorrhage and uterine contractions. Blood loss may be severe and require immediate transfusion. Ergometrine 0.5mg im or iv may also help.
The patient may be in cervical shock. The vaso-vagal effect of the products of conception passing through the cervix causes a reflex bradycardia. In this situation the remaining products of conception should be removed using a sponge-holding forceps. The shock normally resolves spontaneously. Other causes of shock such as hypovolaemia may also occur and are associated with a tachycardia.
In the non-acute presentation a few days after an abortion, continued blood loss and a bulky, tender uterus may suggest that an abortion was incomplete and may necessitate an ERPC.
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