Threatened Abortion (Threatened Miscarriage): Symptoms, Causes, Diagnosis & Management
Last updated: January 4, 2026
Medically reviewed: January 4, 2026
What Is Threatened Abortion?
Threatened abortion, commonly referred to as threatened miscarriage, is a medical term used to describe vaginal bleeding occurring during the first 20 weeks of pregnancy while the cervix remains closed and no pregnancy tissue has been expelled (MedlinePlus).
This condition does not indicate definite pregnancy loss. Many pregnancies continue normally with appropriate monitoring and care.
- Vaginal bleeding is present
- The cervix remains closed
- No fetal tissue has passed
- Pregnancy may remain viable
Common Symptoms
- Light to moderate vaginal bleeding or spotting
- Lower abdominal or pelvic discomfort
- Mild uterine cramping
- Lower back pain
- No cervical dilation on examination
Possible Causes and Risk Factors
In many cases, the exact cause cannot be identified. Known contributing factors include:
- Hormonal imbalance, particularly reduced progesterone levels
- Uterine abnormalities such as fibroids or uterine septum
- Maternal infections
- Physical trauma or excessive exertion
- Advanced maternal age
- History of previous pregnancy loss
How Is Threatened Miscarriage Diagnosed?
Diagnosis relies on clinical assessment combined with investigations such as pelvic examination, transvaginal ultrasound, and serial hCG testing to evaluate pregnancy viability (ACOG Practice Bulletin No. 200).
- Pelvic examination: Confirms closed cervix
- Transvaginal ultrasound: Assesses fetal heartbeat and gestational development
- Serial beta-hCG levels: Evaluates hormone trends over time
- Progesterone testing: Used selectively in some cases
When Is Medical Care Urgent?
| Symptoms | Recommended Action |
|---|---|
| Light spotting, no pain | Observation and scheduled follow-up |
| Moderate bleeding with cramps | Prompt medical evaluation |
| Heavy bleeding, dizziness, severe pain | Seek emergency medical care immediately |
Management and Care Options
Management strategies depend on clinical findings and individual risk factors:
- Expectant management: Monitoring with follow-up visits and ultrasounds
- Progesterone support: Prescribed in selected cases under medical supervision
- Rh immunoglobulin: Administered to Rh-negative women with bleeding
- Hospital care: Required for significant bleeding or instability
Prognosis and Outcomes
Many pregnancies with threatened miscarriage continue to have healthy pregnancies. Prognosis is influenced by fetal cardiac activity, gestational age, bleeding amount, and ultrasound findings (Cleveland Clinic).
- Presence of fetal cardiac activity
- Gestational age at presentation
- Amount and duration of bleeding
- Ultrasound findings such as subchorionic hematoma
Self-Care and Monitoring
- Avoid strenuous physical activity unless advised
- Maintain adequate hydration and nutrition
- Attend all prenatal appointments
- Seek care if symptoms worsen
Emotional and Psychological Support
Early pregnancy bleeding can cause anxiety and emotional distress. Support is an important part of care:
- Communicate openly with healthcare providers
- Seek emotional support from family or trusted individuals
- Use reliable educational pregnancy resources
Recent Clinical Updates (2025–2026)
- WHO emphasizes early assessment of first-trimester bleeding
- Standardized triage protocols improve pregnancy outcomes
- Emerging research explores AI-based prediction models
Internal Resources
Author & Medical Review
Dr Humaira Latif
Registered Medical Practitioner
Specialist in Gynecology & Obstetrics
14 years of clinical experience
Mansehra, Pakistan
References
- World Health Organization (WHO)
- American College of Obstetricians and Gynecologists (ACOG)
- National Institute for Health and Care Excellence (NICE)
- International Federation of Gynecology and Obstetrics (FIGO)
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