Interventions for Maternal Abortion and Miscarriage

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Age Cohort: 25 - 59 years

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
Comprehensive sexuality education in schools and community Mass media, community awareness campaigns and advocacies on abortion and contraceptive methods	Use of effective contraception, including emergency contraception	Recognition of signs and symptoms of abortion	Immediate transfer to a higher-level health care facility
Primary Care
Health education on prevention of unintended pregnancy and contraceptive use	Use of effective contraception, including emergency contraception	History Physical examination Urine pregnancy test Complete blood count	Immediate transfer to a higher-level health care facility Post-abortion provision of contraceptives
Referral Facility: General
Health education on prevention of unintended pregnancy and contraceptive use	Guidance and counselling on use of effective contraception, including emergency contraception	History Physical examination Pelvic examination Urine pregnancy test Complete blood cell (CBC) count Blood grouping Transvaginal ultrasound.	Removal of any retained pregnancy tissues Timely treatment of heavy blood loss Antibiotics Mifepristone and misoprostol combination Misoprostol only Vacuum aspiration Dilatation and evacuation (D&E).) Early referral in case of injury to the genital tract and/or internal organs	Psychosocial and emotional support on abortion, including miscarriage and intrauterine foetal death
Referral Facility: Specialist
Health education on prevention of unintended pregnancy and contraceptive use	Guidance and counselling on use of effective contraception, including emergency contraception	History Physical examination Pelvic exam Urine pregnancy test Complete blood cell (CBC) count Blood grouping Transvaginal ultrasound Transabdominal ultrasound scan Serum beta HCG titres Serum progesterone	Timely treatment of heavy blood loss Antibiotics Removal of any retained pregnancy tissues Mifepristone and misoprostol combination Misoprostol only Vacuum aspiration Dilatation and evacuation (D&E).) Early management of injury to the genital tract and/or internal organs	Psychosocial and emotional support on abortion, including miscarriage and intrauterine foetal death

Age Cohort: 12 - 24 years

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
Comprehensive sexuality education in schools and community Mass media, community awareness campaigns and advocacies on abortion and contraceptive methods	Use of effective contraception, including emergency contraception	Recognition of signs and symptoms of abortion and miscarriage	Immediate transfer to a higher-level health care facility
Primary Care
Health education on prevention of unintended pregnancy and contraceptive use	Effective contraception, including emergency contraception	History Physical examination Urine pregnancy test Complete blood count	History Physical examination Urine pregnancy test Complete blood count
Referral Facility: General
Health education on prevention of unintended pregnancy and contraceptive use	Effective contraception, including emergency contraception	History Physical examination Pelvic examination Urine pregnancy test Complete blood cell (CBC) count Blood grouping Transvaginal ultrasound.	Removal of any retained pregnancy tissues Timely treatment of heavy blood loss Antibiotics Mifepristone and misoprostol combination Misoprostol only Vacuum aspiration Dilatation and evacuation (D&E).) Early referral in case of injury to the genital tract and/or internal organs	Psychosocial and emotional support on abortion, including miscarriage and intrauterine foetal death
Referral Facility: Specialist
Health education on prevention of unintended pregnancy and contraceptive use	Effective contraception, including emergency contraception	History Physical examination Pelvic exam Urine pregnancy test Complete blood cell (CBC) count Blood grouping Transvaginal ultrasound Transabdominal ultrasound scan Serum beta HCG titres Serum progesterone	Timely treatment of heavy blood loss Antibiotics Removal of any retained pregnancy tissues Mifepristone and misoprostol combination Misoprostol only Vacuum aspiration Dilatation and evacuation (D&E).) Early management of injury to the genital tract and/or internal organs	Psychosocial and emotional support on abortion, including miscarriage and intrauterine foetal death

Age Cohort: Pregnancy and newborn

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
Comprehensive sexuality education in schools and community Mass media, community awareness campaigns and advocacies on abortion and contraceptive methods	Use of effective contraception, including emergency contraception ANC attendance	Recognition of signs and symptoms of abortion and miscarriage	Immediate transfer to a higher-level health care facility		Psychosocial support for physical and emotional recovery
Primary Care
Health education and information on abortion and contraceptive methods	Quality ANC Guidance and counselling on use of effective contraception, including emergency contraception	History Physical examination Urine pregnancy test Complete blood count	Immediate transfer to a higher-level health care facility Post-abortion provision of contraceptives		Psychosocial support for physical and emotional recovery
Referral Facility: General
Health education and information on abortion and contraceptive methods	Quality ANC Guidance and counselling on use of effective contraception, including emergency contraception	History Physical examination Pelvic examination Urine pregnancy test Complete blood cell (CBC) count Blood grouping Transvaginal ultrasound.	Removal of any retained pregnancy tissues Timely treatment of heavy blood loss Antibiotics Mifepristone and misoprostol combination Vacuum aspiration Dilatation and evacuation (D&E) Early referral in case of injury to the genital tract and/or internal organs	Post-abortion counselling, education and family-planning services	Psychosocial support for physical and emotional recovery
Referral Facility: Specialist
Health education and information on abortion and contraceptive methods	Quality ANC Guidance and counselling on use of effective contraception, including emergency contraception	History Physical examination Pelvic exam Urine pregnancy test Complete blood cell (CBC) count Blood grouping Transvaginal ultrasound Transabdominal ultrasound Serum beta HCG Serum progesterone	Timely treatment of heavy blood loss Antibiotics Removal of any retained pregnancy tissues Mifepristone and misoprostol combination Vacuum aspiration Dilatation and evacuation (D&E) Early management of injury to the genital tract and/or internal organs	Post-abortion counselling, education and family-planning services	Psychosocial support for physical and emotional recovery