유산 문헌고찰 보고서

문서 내 토픽

1. Threatened abortion(절박유산)

임신 유지가 가능하다는 점에서 계류, 완전, 불완전 유산 등과는 구별됩니다. 침상 안정, 성관계 금지, 질 분비물 관찰, 아세트아미노펜 이용한 통증치료, 질 초음파, 혈청 hCG 및 황체 호르몬(progesterone) 측정 등의 간호중재가 필요합니다.
2. Inevitable abortion(불가피유산)

임신 유지가 불가능하며, 자궁경관이 개대되어 있습니다. 하복부 통증과 출혈이 지속되며, 양막이 터지고 자궁 문이 열리면서 하혈과 함께 태아와 임신 부산물이 빠져나옵니다. 출혈이 심하고 계속될 때는 즉시 수혈과 함께 자궁내막 소파술(D&C)을 시행해야 합니다.
3. Incomplete abortion(불완전유산)

임신 유지가 불가능하며, 자궁경관이 개대되어 있습니다. 태아나 태반의 일부가 자궁 내 남아있는 상태입니다. 수혈, 소파술, 항생제 투여 등의 간호중재가 필요합니다.
4. Complete abortion(완전유산)

임신 유지가 불가능하며, 자궁경관이 닫혀있습니다. 태반 및 수태산물이 모두 배출되었습니다. 자궁수축제 3~5일간 투여, 출혈 및 감염징후 관찰, 성관계 금지, 안정 및 휴식 등의 간호중재가 필요합니다.
5. Missed abortion(계류유산)

임신 유지가 불가능하며, 자궁경관이 닫혀있습니다. 태아가 사망한 채로 자궁 내 존재하며, 임신반응검사에서 음성(-)으로 바뀝니다. 대부분 무증상이거나 소량의 출혈이 발생하지만, 다량의 출혈이 있는 경우 자연유산이 진행되는 단계일 수 있습니다. 파종성 혈액응고장애(DIC), 저섬유소혈증 등의 징후를 사정해야 합니다.
6. Septic abortion(패혈유산)

중증의 치명적인 감염으로 인한 유산입니다. 출혈 시 악취, 발열, 패혈증을 동반합니다. 기간에 따라 적합한 방법으로 즉시 임신을 종결하고, 자궁경관내 균 배양검사, 민감도 검사를 하여 광범위 항생제를 투여해야 합니다. 필요에 따라 패혈성 쇼크 치료도 필요합니다.
7. Habitual abortion(습관성 유산)

임신 5개월(20주)이전에 2~3차례 이상 계속해서 유산한 경우입니다. 질출혈 또는 하복부 통증으로 나타나거나, 증상 없이 정기적인 산전 진찰 시 발견될 수 있습니다. 원인에 따라 적절한 유전적 상담, 자궁 수술, 항인지질항체 치료, 면역글로불린 및 약물 투여, 감염 치료 등의 다양한 방법으로 치료할 수 있습니다.

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1. Threatened abortion(절박유산)

Threatened abortion, also known as a threatened miscarriage, is a condition where there is vaginal bleeding or other signs of potential pregnancy loss, but the fetus is still alive and the cervix remains closed. This is a common occurrence in early pregnancy, affecting up to 20% of pregnancies. While it can be a concerning situation, many women with threatened abortion go on to have a healthy pregnancy and delivery. The key is to seek prompt medical attention, follow the recommendations of healthcare providers, and try to reduce stress and activity levels during this time. With proper monitoring and care, the pregnancy often continues without further complications. It's important to remain hopeful and focus on the well-being of the developing baby.
2. Inevitable abortion(불가피유산)

Inevitable abortion, also called an inevitable miscarriage, is a situation where the cervix has dilated and the membranes have ruptured, making a miscarriage unavoidable. This can occur due to factors like severe placental abruption, cervical incompetence, or uterine abnormalities. In these cases, the pregnancy cannot be saved, and the focus shifts to managing the miscarriage process safely and minimizing any potential complications for the woman. Healthcare providers will typically recommend options like expectant management, medication to assist the miscarriage, or a surgical procedure to remove the pregnancy tissue. While an inevitable abortion is a difficult experience, it's important for the woman to receive compassionate care, emotional support, and information about the process and her options. With proper medical attention, the risk of complications can be reduced, and the woman can begin the healing process both physically and emotionally.
3. Incomplete abortion(불완전유산)

An incomplete abortion, also known as a partial miscarriage, occurs when the pregnancy tissue is expelled from the uterus, but some remains behind. This can lead to ongoing bleeding, cramping, and the risk of infection. Incomplete abortions require prompt medical attention to ensure the remaining tissue is removed, either through medication or a surgical procedure like a dilation and curettage (D&C). Leaving an incomplete abortion untreated can lead to serious complications, so it's crucial for the woman to seek care from a healthcare provider. With proper management, the risk of complications can be minimized, and the woman can recover both physically and emotionally from the experience of an incomplete abortion. It's important to provide compassionate support and education to help the woman understand the process and her options for treatment.
4. Complete abortion(완전유산)

A complete abortion, or complete miscarriage, is a situation where all of the pregnancy tissue has been expelled from the uterus, and the cervix has closed. This is considered a natural and normal outcome of a miscarriage, as the body has successfully completed the process of pregnancy loss. While a complete abortion can still be an emotionally difficult experience, it generally carries a lower risk of complications compared to other types of miscarriage. The woman may still experience bleeding and cramping, but these symptoms typically resolve within a week or two. Healthcare providers will often recommend expectant management, allowing the body to complete the process naturally, or may prescribe medication to help expel any remaining tissue. With proper monitoring and support, a complete abortion can allow the woman to begin the healing process, both physically and emotionally, and prepare for a future pregnancy if desired.
5. Missed abortion(계류유산)

A missed abortion, also known as a missed miscarriage, is a situation where the fetus has died, but the pregnancy tissue has not been expelled from the uterus. This can occur without the woman experiencing any obvious symptoms of miscarriage, such as bleeding or cramping. Missed abortions are often discovered during a routine prenatal ultrasound or when the woman reports a lack of pregnancy symptoms. While a missed abortion does not pose an immediate threat to the woman's health, it is important to seek medical attention to manage the situation. Healthcare providers may recommend options like medication to induce the miscarriage, or a surgical procedure to remove the pregnancy tissue. Missed abortions can be emotionally challenging, as the woman may have been unaware of the loss and may need additional support and counseling during this difficult time. With proper medical care and emotional support, the woman can navigate the process of a missed abortion and begin the healing process.
6. Septic abortion(패혈유산)

A septic abortion, also known as an infected abortion, is a serious and potentially life-threatening complication that can occur during a miscarriage or abortion. It is characterized by an infection in the uterus, often caused by the presence of bacteria or other pathogens. Symptoms may include fever, chills, abdominal pain, and foul-smelling vaginal discharge. Septic abortions require immediate medical attention, as the infection can quickly spread and lead to sepsis, a potentially fatal condition. Treatment typically involves antibiotics, and in some cases, a surgical procedure to remove any remaining pregnancy tissue. It is crucial for healthcare providers to recognize and promptly manage septic abortions to prevent severe complications and ensure the woman's safety. Ongoing support and monitoring are essential during the recovery process, as the woman may also need emotional support to cope with the traumatic experience.
7. Habitual abortion(습관성 유산)

Habitual abortion, also known as recurrent pregnancy loss, is a condition where a woman experiences three or more consecutive miscarriages. This can be a deeply distressing and challenging situation for the woman and her partner. Potential causes of habitual abortion include genetic factors, hormonal imbalances, autoimmune disorders, uterine abnormalities, and other medical conditions. Thorough evaluation and testing by a healthcare provider are essential to identify the underlying cause and develop an appropriate treatment plan. This may involve medications, surgical interventions, or assisted reproductive technologies, depending on the specific factors contributing to the recurrent losses. Emotional support and counseling are also crucial during this process, as the experience of multiple miscarriages can be traumatic and take a significant toll on the woman's mental health. With a comprehensive, compassionate, and personalized approach, many women with habitual abortion can go on to have successful pregnancies and deliveries.

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