Threatened Miscarriage: Causes, Symptoms And Risk Factors

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A threatened miscarriage or abortion is defined as vaginal bleeding during the first three months or by 20 weeks of pregnancy. After a threatened abortion, some women may have a healthy pregnancy, while others may have a miscarriage or pregnancy loss.

If you have a threatened pregnancy loss, you may need the help of a healthcare expert to figure out what’s causing it and come up with a treatment and management plan.

Read on to know more about the causes, risk factors, symptoms, complications, and management of threatening abortion.

Causes Of Threatened Abortion

The common causes of a threatened miscarriage, which is vaginal bleeding, may include(1)(2):

• Infections
• Miscarriage
• Molar pregnancy
• Chronic illnesses, such as diabetes, high blood pressure, and thyroid problems
• Alcohol use
• Recreational drug use
• Uterine factors – septum, fibroids, polyps
• Cervix is incompetent and cannot hold the pregnancy
• Genetic causes like abnormal embryo
• Immunological cause

怀孕早期出血可以将小问题s in the uterus, cervix, vagina, or the external genitalia. It can often be due to implantation or irritation that may occur aftersexual intercourse.

Fetal problems such as chromosomal abnormalities may cause threatened miscarriage or miscarriage in thefirst trimester(first three months) of pregnancy. In contrast, second-trimester miscarriages can be due to maternal factors such as diabetes, hypertension, ibroids malformation of uterus, etc.

Symptoms And Signs Of Threatened Abortion

Vaginal bleedingis the main symptom of threatened miscarriage, and it can be light or heavy bleeding. Some women may experiencecrampingorabdominal pain, along with bleeding(2).

You may havelight spottingorheavy blood loss,blood clots, and may feelpain in the pelvis or lower back.

Duration of vaginal bleeding during threatened miscarriage may vary in each pregnant woman, depending on the causing factor. You may contact your doctor if you are experiencing vaginal bleeding during pregnancy, even if light or without belly pain.

Risk Factors Of Threatened Miscarriage

The risk factors for threatened miscarriage can be high in the following situations(2).

• Presence of infections
• History of trauma
• Usage of certain medications
• Advanced maternal age
• Previous history of abortions

In case ofhigh feveror other illnesses, you may seek medical care during pregnancy. Always take medications and supplements that are safe during pregnancy.

Complications Of Threatened Abortion

Possible complications of threatened abortion may include the following(3).

• Moderate and heavy bleeding may result in anemia

• Increased risk for infections
• May result in miscarriage

The complications may vary depending on the causes.

When To Call A Doctor For A Threatened Miscarriage?

You may seek medical care if you are having any symptoms of threatened miscarriage. Early diagnosis and treatment may give better outcomes.

It is recommended to seek your doctor’s advice and have prescription medication for any health concerns or illnesses during pregnancy.

How Is A Threatened Miscarriage Diagnosed?

Your doctor may diagnose threatened abortion based on your symptoms and medical history, along with physical examination (pelvic exam) to confirm vaginal bleeding. The following tests can be ordered for a detailed analysis of fetus and maternal status(4).

• Blood tests: These may help identify the levels of pregnancy hormone, human choriogonadotropin (hCG), and any anemia or B sugar. It may also help determine the blood type and administer RhoGAM medicine to prevent blood interaction with the fetus if you are RH negative with a partner who is RH positive blood type.

• Urine tests: Urinalysis is often helpful in identifying urinary tract infections (UTIs) or asymptomatic bacteriuria (bacteria in the urine).

• Ultrasound: Ultrasound of pelvis can be done to look at the fetus and placenta. It may help assess the presence of fetus, location of pregnancy (ectopic pregnancy), and any other abnormalities.

• Fetal heart monitoring: Fetal heart rate is seen.

Your doctor may also order a few other tests based on your health status and cause of threatened miscarriage.

Threatened Miscarriage Treatment

Many pregnant women can get well without any treatment if they have light spotting or not lasting bleeding. However, a few pregnant women may require some interventions to continue the pregnancy. This may include(4):

• Medications, such asprogesterone hormonesgiven to continue the pregnancy. This female hormone supports a pregnancy.

• Rho immune globulin,which is given if the mother has Rh-negative blood type and prevents interaction with fetal blood through the formation of antibodies against fetal blood.

• Bed restandminimal activity, along with medications, in case of heavy bleeding.

• Fluid and electrolyte replacementby intravenous fluids orblood transfusion, sometimesrequired in severe blood loss and dehydration.

• Antibioticsprescribed to treat bacterial infection.

• Control of Maternal diabetes, hypertension, and hypothyroidism

• Pain medications, if required.

It is essential to seek medical care to safeguard your pregnancy in a threatened miscarriage. Your doctor can identify the cause and give relevant treatment to manage the condition.

Is A Surgery Required For Threatened Miscarriage?

Not all women who undergo threatened abortion require surgical procedures. If there is cervical incompetence (weakness of cervix), then cervical cerclage (cervical stitch) is done. This is usually done in the second trimester of pregnancy.

Note:Dilation and curettage (D & C) procedures are done after the miscarriage to clear any remaining products of conception in the uterus(5). This may often be delayed in the presence of pelvic infection and contraindicated in clotting disorders and other medical problems.

What Is The Long-term Outlook?

The prognosis of threatened abortion may vary based on maternal and fetal health status and etiologic factors (causes).

More than 50% of threatened abortion or vaginal bleeding occurs in the first 12 weeks of gestation, but most women continue to have a healthy pregnancy(4). However, others can have continued bleeding that may often end in a miscarriage.

Pregnant women with threatened miscarriages have an increased miscarriage risk than others. Seek medical care if you have any vaginal bleeding or discomfort during pregnancy.

Prevention Of Threatened Miscarriage

Prevention of threatened miscarriage may not be possible in all cases. However, proper prenatal care could reduce the risk(3).

Proper management of diabetes and hypertension (high blood pressure) during pregnancy and early treatment of infections can be helpful. You should also avoid recreational drugs, over-the-counter medications, smoking, and alcohol during pregnancy since these may lead to bleeding and other pregnancy complications.

You may also take recommended vitamin and mineral supplements, such as iron supplement or folic acid supplement, as per the gynecologist’s prescription to reduce the risk of miscarriage and to promote a baby’s health.

What Should You Do After A Threatened Miscarriage?

If you experience threatened miscarriage or miscarriage, then the first thing to do is to seek medical care. The below-listed suggestions can be followed after a miscarriage(6).

• Take rest to feel better
• 不插入棉条into the vagina
• Do not douche vagina with chemicals or any other products
• Avoid sexual intercourse until you are well
• Visit the emergency room if you have a high fever, cramping, heavy bleeding, or miscarriage.

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