WHAT IS A THREATENED ABORTION?
A threatened abortion or a threatened miscarriage is vaginal bleeding that occurs in the first 20 weeks of pregnancy and is sometimes accompanied by abdominal cramps.
The exact cause of a threatened abortion usually isn’t known. But it’s more common among people who previously had a miscarriage.
Miscarriage is a relatively common experience — but that doesn’t make it any easier. Take a step toward emotional healing by understanding what can cause a miscarriage, what increases the risk and what medical care might be needed.
WHAT ARE THE TYPES OF MISCARRIAGE?
Your pregnancy care provider may diagnose you with the following types of miscarriage:
- Missed miscarriage: You’ve lost the pregnancy but are unaware it’s happened. There are no symptoms of miscarriage, but an ultrasound confirms the fetus has no heartbeat.
- Complete miscarriage: You’ve lost the pregnancy and your uterus is empty. You’ve experienced bleeding and passed fetal tissue. Your provider can confirm a complete miscarriage with an ultrasound.
- Recurrent miscarriage: Three consecutive miscarriages. It affects about 1% of couples.
- Threatened miscarriage: Your cervix stays closed, but you’re bleeding a nd experiencing pelvic cramping. The pregnancy typically continues with no further issues. Your pregnancy care provider may monitor you more closely for the rest of your pregnancy.
- Inevitable miscarriage: You’re bleeding, cramping and your cervix has started to open (dilate). You may leak amniotic fluid. A complete miscarriage is likely.
WHAT ARE THE SIGNS AND SYMPTOMS OF A THREATENED ABORTION?
Signs and symptoms of a miscarriage might include:
- Vaginal spotting or bleeding
- Pain or cramping in your abdomen or lower back
- Fluid or tissue passing from your vagina
If you have passed fetal tissue from your vagina, place it in a clean container and bring it to your health care provider’s office or the hospital for analysis.
Most women who have vaginal spotting or bleeding in the first trimester go on to have successful pregnancies.
WHO IS AT RISK FOR THREATENED ABORTION?
The actual cause of a threatened abortion isn’t always known. Still, certain factors may increase your risk of having one. These include:
- a bacterial or viral infection during pregnancy
- trauma to the abdomen
- advanced parental age (over age 35)
- exposure to certain medications or chemicals
Other risk factors for a threatened abortion include obesity, unmanaged diabetes, and unmanaged thyroid disease. If you’re overweight, have diabetes, or have thyroid disease, speak with your doctor about ways to stay healthy during pregnancy.
You should also tell your doctor about any medications or supplements you take. Some may be unsafe to use during pregnancy.
WHAT ARE THE CAUSES OF A THREATENED ABORTION?
1. Problems with the genes or chromosomes
Most miscarriages occur because the foetus isn’t developing as expected. About 50 percentage of miscarriages are associated with extra or missing chromosomes. Most often, chromosome problems result from errors that occur by chance as the embryo divides and grows — not problems inherited from the parents.
Chromosome problems might lead to:
- Blighted ovum. Blighted ovum occurs when no embryo forms.
- Intrauterine fetal demise. In this situation, an embryo forms but stops developing and dies before any symptoms of pregnancy loss occur.
- Molar pregnancy and partial molar pregnancy. With a molar pregnancy, both sets of chromosomes come from the father. A molar pregnancy is associated with abnormal growth of the placenta; there is usually no fetal development.
A partial molar pregnancy occurs when the mother’s chromosomes remain, but the father provides two sets of chromosomes. A partial molar pregnancy is usually associated with abnormalities of the placenta, and an abnormal foetus.
Molar and partial molar pregnancies are not viable pregnancies. Molar and partial molar pregnancies can sometimes be associated with cancerous changes of the placenta.
Maternal health conditions
In a few cases, a mother’s health condition might lead to miscarriage. Examples include:
- Uncontrolled diabetes
- Hormonal problems
- Uterus or cervix problems
- Thyroid disease
What does not cause miscarriage?
Routine activities such as these don’t provoke a miscarriage:
- Exercise, including high-intensity activities such as jogging and cycling.
- Sexual intercourse.
- Occupation: provided you’re not exposed to harmful chemicals or radiation. Talk with your doctor if you are concerned about work-related risks.
HOW IS A THREATENED ABORTION DIAGNOSED?
Your doctor will perform a pelvic exam if a threatened abortion is suspected. During a pelvic exam, your doctor will examine your reproductive organs, including your vagina, cervix, and uterus.
They’ll look for the source of your bleeding and determine whether the amniotic sac has ruptured. The pelvic exam will take only a few minutes to complete.
An ultrasound will monitor the heartbeat and development of the fetus. It can also help determine the amount of bleeding. A transvaginal ultrasound, or an ultrasound that uses a vaginal probe, is typically more accurate than an abdominal ultrasound in early pregnancy.
During a trans-vaginal ultrasound, your doctor will insert an ultrasound probe about 2 or 3 inches into your vagina. The probe uses high-frequency sound waves to create images of your reproductive organs, allowing your doctor to see them in more detail.
Blood tests, including a complete blood count, may also be performed to check for abnormal hormone levels. Specifically, these tests will measure the levels of hormones in your blood called human chorionic gonadotropin (HCG) and progesterone.
HCG is a hormone that your body produces during pregnancy, and progesterone is a hormone that supports a pregnancy. Atypical levels of either hormone may indicate a problem.
HOW IS THREATENED ABORTION TREATED IN OUR FACILITY?
A miscarriage often can’t be prevented. In some cases, though, we may suggest ways to lower your risk of having a miscarriage.
As you recover, our medical staff may tell you to avoid certain activities. Bed rest and avoiding sexual intercourse may be suggested until your symptoms go away. However, there is no research to back up these suggestions.
We will also treat conditions that increase the risk of complications during pregnancy, such as diabetes or hypothyroidism.
We may also want to give you a progesterone injection to increase hormone level and also administer Rh immunoglobulin if you have Rh-negative blood and your developing fetus has Rh-positive blood. This stops your body from creating antibodies against your child’s blood.
WHAT ARE THE COMPLICATIONS?
Some women who miscarry develop an infection in the uterus. This is also called a septic miscarriage. Signs and symptoms of this infection include:
- Lower abdominal tenderness
- Foul-smelling vaginal discharge
WHAT ARE THE PREVENTIONS?
Often, there’s nothing you can do to prevent a miscarriage. Simply focus on taking good care of yourself and your baby:
- Seek regular prenatal care.
- Avoid known miscarriage risk factors — such as smoking, drinking alcohol and illicit drug use.
- Take a daily multivitamin.
- Limit your caffeine intake. A recent study found that drinking more than two caffeinated beverages a day appeared to be associated with a higher risk of miscarriage.
If you have a chronic condition, work with your health care team to keep it under control.
WHAT IS THE LONGTERM OUTLOOK?
Many people who experience a threatened abortion go on to deliver healthy babies. This is more likely if your cervix isn’t already dilated and the fetus is still securely attached to the wall of your uterus. If you have atypical hormone levels, hormone therapy can often help you carry the baby to term.
Approximately 50%Trusted Source of people who experience a threatened abortion don’t have a miscarriage. Most people who do miscarry will go on to have successful pregnancies in the future. But you should see your doctor to discuss possible causes if you’ve experienced two or more miscarriages in a row.
For some people, a threatened abortion is a very stressful experience and can lead to anxiety and depression. It’s important to talk with your doctor if you’re experiencing symptoms of either condition following a threatened abortion or miscarriage. They can help you get the treatment you need.
Your doctor may also know about local support groups where you can discuss your experience and concerns with others who can relate to what you’re experiencing.
HOW TO MAINTAIN A HEALTH PREGNANCY?
It’s difficult to prevent a miscarriage, but certain behaviours can help support a healthy pregnancy. These include:
- avoiding drinking alcohol
- avoiding smoking cigarettes
- not using illegal drugs
- minimizing consumption of caffeine
- avoiding certain foods that can make you ill and harm your fetus
- avoiding exposure to toxic chemicals or harsh cleaning solutions
- promptly treating any viral or bacterial infections that occur
- taking prenatal vitamins, such as folic acid
- exercising at least 2 hours a week
You can also maintain a healthy pregnancy by getting early, comprehensive prenatal care. Receiving prompt prenatal care makes it possible for your doctor to detect and treat any potential health problems early in the pregnancy. This will prevent complications and help ensure the delivery of a healthy baby.
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