What does diagnosis mean?
The term “threat” is used when there is spotting, but the pregnancy continues: the cervix is closed, an ultrasound detects a fertilized egg in the uterus, and after 6–7 weeks the heartbeat of the embryo is detected. This distinguishes the threat from an ongoing and incomplete miscarriage, a non-developing and ectopic pregnancy. Light spotting may be associated with implantation, a small retrochorial hematoma, a polyp, or cervical irritation after examination or proximity.
- Threatened miscarriage - the cervix is closed, the embryo is alive
- Beginning - the cervix opens
- Incomplete - part of the fertilized egg has come out
- Non-developing pregnancy - the embryo does not develop
- Ectopic pregnancy - fertilized egg outside the uterus
Causes and risk factors
Most first trimester miscarriages are caused by chromosomal errors during embryonic cell division. Such pregnancies cannot be preserved with medications, and their termination is not the woman’s fault. Physical activity, work, moderate sex, flying and stress alone do not cause miscarriage. The probability is higher in case of some diseases of the mother, which are better compensated for before pregnancy.
- Mother's age over 35 years
- Two or more miscarriages in the past
- Uncontrolled diabetes mellitus, thyroid disease
- Antiphospholipid syndrome
- Anomalies in the structure of the uterus, fibroids, deforming cavity
- Smoking, alcohol
Symptoms
The discharge can be spotting brown, pink or bright red, sometimes accompanied by a nagging pain in the lower abdomen or lower back, similar to menstrual pain. The severity of bleeding does not always reflect the prognosis, so a doctor must evaluate the situation. An alarming sign is the disappearance of nausea and breast engorgement, along with increased pain and bleeding.
- Brown or bloody spotting
- Bright red discharge
- Nagging pain in the lower abdomen
- Lower back pain
- Sometimes - a feeling of pressure in the perineum
Survey
The doctor examines the cervix using a speculum, assesses the amount of bleeding and rules out other sources. Transvaginal ultrasound shows the location of the ovum, the heartbeat of the embryo, and the presence of a hematoma. If the period is too short and the ultrasound does not give an answer, hCG is determined twice with an interval of 48 hours and the ultrasound is repeated. For a Rh-negative woman, the Rh factor is checked and, if necessary, anti-Rhesus immunoglobulin is administered.
- Inspection in the mirrors
- Transvaginal ultrasound
- hCG in dynamics
- Blood type and Rh factor
- Complete blood count for heavy bleeding
Treatment and what to do
If the embryo is alive, special treatment is often not required: the bleeding subsides and the pregnancy develops. Strict bed rest has not been shown to be beneficial, but heavy exercise should be avoided while the discharge continues. The doctor can prescribe progesterone drugs to women with bleeding and miscarriages in the past - the decision is made individually. Antispasmodics, hemostatic agents and vitamins for “preservation” are not used without indications. Do not use tampons or douches.
- Examination by an obstetrician-gynecologist on the same day
- Control ultrasound at the appointed time
- Progesterone - only as prescribed by a doctor
- Anti-Rhesus immunoglobulin for Rh-negative blood
- Quitting smoking and alcohol
- Call 103 for heavy bleeding
