Threatened Miscarriage: What You Need to Know:
This article was written and Updated:on March 16, 2020.
by Dr Humaira Latif MBBS from KMU (Khyber Medical University) in Pakistan.Gynecologist and Obstetrician, Ultrasound Specialist, 14 years of clinical experience.
Disclaimer:
This article provides educational / informative content only. It is not to be used in place of professional medical advice, diagnosis and/or treatment.
Introduction:
Bleeding during the early days of your pregnancy is very common. Quite a few women will experience some light spotting or bleeding throughout their pregnancy due to multiple reasons. This has caused many women to feel worried and confused about the overall health of their pregnancy.
One possible cause of this is something called threatened miscarriage or threatened abortion in medical terminology.
Prevalence of Threatened Abortions:
Studies show that approximately 20-25% of pregnancies will experience some type of bleeding in the first trimester of pregnancy. Many of the described pregnancies will go on to develop normally with careful monitoring.
Definition Of Threatened Abortion!
A threatened miscarriage is defined as bleeding from inside your uterus vaginal bleeding during your pregnancy, while at the same time the cervix is still closed and your baby is still alive (inside the uterus).
Generally, many pregnancies will continue to be successful with adequate monitoring and care. The following information will be discussed:
- Symptoms
- Causes
- Risk factors
- Diagnosis
- Treatment options
- Ways to Prevent
The purpose of this information is to allow for an informative understanding of the condition in a calm manner.
Contents of Table of Contents:
- What is threatened (frightened) miscarriage?
- How frequently is it happening?
- When do I have to do a breast reconstruction?
- How do I find out if I have lost my baby after a miscarriage?
- What are the chances of having a normal pregnancy after a threatened (frightened) miscarriage?
- What does it feel like to have a threatened (frightened) miscarriage?
- Is a threatened (frightened) miscarriage the same as a missed or planned loss?
1.What is a threatened or frightened miscarriage?
A threatened or frightened miscarriage occurs when there is vaginal bleeding during the first twenty weeks of gestation, although the cervix not dilated and the fetus is still alive. A doctor can confirm the diagnosis by examining the patient and performing an ultrasound.
Some key points about a threatened or frightened miscarriage are:
• There may be purplish or brownish bleeding in early-pregnancy
• The cervix is closed when examined
• The pregnancy may continue as normal
• The baby usually has fetal heart sounds
If the patient receives proper supervision, many women do very well in this condition.
2.How common is a threatened (frightened) miscarriage?
More than 70% of women experience some type of bleeding in their early pregnancies.
3.Signs of a Possible Miscarriage:
There are many different signs of a possible miscarriage and the symptoms can range from mild to moderate, with some women only experiencing a small amount of spotting.
The common signs and symptoms of a possible miscarriage include:
1.Vaginal Bleeding.
- Light Spotting
- Pink or Brown Vaginal Discharge
- Mild Bleeding, Like a Light Menstrual Cycle.
2.Mild Abdominal Pain.
- Discomfort in the Lower Abdomen
- Mild Cramping
- Pressure in the Pelvis
- Back Pain
- Dull Lower Back Pain
- Mild Pressure in Lower Back.
The symptoms of a possible miscarriage may appear suddenly or develop slowly. If you experience heavy vaginal bleeding and have severe abdominal pain, you should seek medical care.
4.Possible Causes of a Miscarriage:
In some instances, no specific cause has been identified for the threatened miscarriage, but how many medical problems may lead to a threatened miscarriage?
1. Chromosomal Abnormalities:
There may be chromosomal abnormalities present in an embryo which may interfere with the early development of the embryo.
2. Hormonal Problems:
Low levels of progesterone which provides the necessary hormone support for the pregnancy, may result in an inability to maintain a pregnancy.
3. Implantation Bleeding:
When an embryo attaches to the uterine wall, a small amount of bleeding may occur.
4. Subchorionic Hemorrhage:
A small amount of blood accumulates near the placenta, and this blood can cause spotting.
5. Infection:
Some types of infections may irritate the lining of the uterus.
6. Physical Trauma:
Heavy activity or physical trauma may, on occasion, cause spotting from a pregnant woman.
5. Risk Factors:
Certain women have an increased likelihood of having a threatened miscarriage
Factors That Lead To A Higher Likelihood Of A Threatened Miscarriage Are
- Previous history of miscarriage
- Maternal age >35
- Use of tobacco or alcohol
- Poorly-controlled diabetes
- Thyroid problems
- Uterine abnormalities
- Hormonal imbalances
Being monitored by your doctor throughout your pregnancy will help reduce some risk-related issues.
6. Diagnosis Of Threatened Miscarriage:
Your doctor will evaluate the presence of a threatened miscarriage through a thorough examination as well as specific testing
1.Medical history
Questions That Your Doctor May Ask You To Establish A Medical History Will Include:
- Symptoms of bleeding
- Symptoms of pain
- The number of pregnancies you have had in the past
2. Physical Examination:
A pelvic examination will provide information about your cervix (whether it is open or closed).
3. Obstetric Ultrsound Examination:
Ultrasound will be used to confirm
A heartbeat is present
Development of the fetus within the womb is progressing normally.
Location and attachment of the placenta.
4. Blood Tests:
Blood tests may be performed to measure
- Beta HCG levels in serum.
- Progesterone levels
- Blood type and Rh factor
Evaluating how to treat and care for an threatened miscarriage will depend on the presenting symptoms and condition of the pregnancy.
7.Treatment Of Threatend Abortion:
Through careful observation, treatment may include one or more of the following:
1.Resting and reducing physical activities; avoiding any heavy lifting or anything that would strain your body.
2. If the doctor thinks it is due to low progesterone, he/she might put you on a progesterone supplementation.
3. Eating a well-balanced diet and staying hydrated will help maintain the health of the mother as well as the baby.
4. Stopping smoking or drinking alcohol, because it can adversely affect the fetus.
5. Regular Antinatal visits, will include ultrasounds and check-ups, will allow the doctor to monitor fetal growth.
8.Risk Of Threatend Abortion:
There are certain risk factors that can increase the likelihood of having a threatened miscarriage
Some conditions that have been shown to increase the risk of threatened miscarriage:
- Prior history of a miscarriage
- Maternal Age > 35 years
- Tobacco or alcohol use
- Poorly controlled type 1 diabetes
- Thyroid problems
- Uterine abnormalities
- Hormonal Imbalances
The doctor will assist in assessing some potential sources of risk during your pregnancy, through ongoing monitoring of your pregnancy.
9.Prevention Of Threatend Abortion:
What can be done to help prevent these risks?
While not all threatened miscarriages can be prevented, maintaining a healthy lifestyle can provide the best support for a healthy pregnancy. Some healthy habits you can develop include:
1) attending prenatal visits early in your pregnancy
2) taking prenatal vitamins containing folic acid
3) eating a healthy diet (not lo-cal diets!)
4) maintaining good control of any chronic illness you may have
5) removing any substance that could harm you and thus your developing fetus.
10.Emotional Support:
It is very common to be stressed and anxious during the pregnancy process; therefore, finding emotional support from close family and friends as well as medical professionals can help maintain your emotional well-being.
11.When to see a physician:
Seek a doctor immediately if any of these symptoms occur:
1) excessive bleeding
2) extreme abdominal pain
3) dizziness or fainting
4) fever and/or infection
5) passing of any tissue from vagina.
Early detection can improve the chance for an ideal outcome.
12.FAQ:
Q1:Can a threatened loss of pregnancy result in a successful pregnancy?
Yes, many pregnancies that are lost have mild amounts of bleeding, and a baby can continue to be growing healthy while they have mild amounts of bleeding.
Q2:Is bed rest prescribed?
Some doctors may prescribe some bed rest, but it isn't always needed unless prescribed by a physician.
Q3:How long will there be bleeding?
It can last from a few hours to several days depending on the reason for the bleeding.
Q4:Will Progesterone therapy help?
Progesterone therapy can help support the pregnancy in women that have a hormone problem.
Q5:Is spotting in the 1st trimester normal?
Some women may spot in the 1st trimester, but it should always be checked out by your doctor.
13.Internal Resources From Our Blog:
If you want to learn more about pregnancy care and women’s health, you may also read these helpful articles available on our blog.
1. Early Pregnancy Warning Signs.
2. Importance of Antenatal Care During Pregnancy
3. Placenta Previa in Pregnancy
4. Healthy Pregnancy Nutrition Guide
14. In conclusion:
Threatened loss of pregnancy is seen quite often during the 1st trimester and usually is associated with mild blood loss from the vagina, with the cervix noted to be 'closed'.
Many pregnancies will continue through an unplanned loss after receiving appropriate medical care, good monitoring of their pregnancy, and health professional advice.
As early as possible, seeking an ultrasound exam along with receiving proper prenatal health care and see your health provider, has the best chance to ensure the best outcome for a mother and her child.
If you experience bleeding during pregnancy, you should contact your doctor immediately, to provide you with the reassurance you need and the necessary medical care you require.
About Dr Humaira Latif MBBS:
A Physician with 14 years experience in women's health & obstetrics, specializing in Gynecology / Obstetrics and being registered specialist for ultrasound.
15. References:
1. American College of Obstetricians and Gynecologists
Practice Bulletin: Early Pregnancy Loss
Updated 2024
2.World Health Organization.
Maternal and Pregnancy Health Guidelines
Updated 2023
3.National Health Service (United Kingdom).
Educational Resource: Bleeding in Early Pregnancy
Updated July 2024
4. Mayo Clinic.
Medical Guide: Miscarriage Symptoms and Causes
Updated October 2024
5.Royal College of Obstetricians and Gynaecologists.
Clinical Guidance on Early Pregnancy Bleeding
Updated 2023
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