Threatened Miscarriage

Pregnancy is a very special time for prospective parents and their families. However, it is also a time for an expectant mother to be extremely careful, as any external changes can have an effect on the baby growing inside her womb.

This is especially true during the first trimester when chances of miscarriage are particularly high. However, sometimes you may develop the signs of miscarriage but not actually be miscarrying. This is known as a threatened miscarriage.

What is a Threatened Miscarriage

During the first 20 weeks of pregnancy, between 20% and 30% of women display signs of a miscarriage, like vaginal bleeding or spotting. Yet, upon further examination by a doctor, everything seems fine with the baby. This condition is known as threatened miscarriage or, in medical terms, threatened abortion and indicates that there is a chance that a pregnancy may end in miscarriage.

The common signs of a threatened miscarriage are:

• Vaginal bleeding
• Spotting
• Bloodstains or discharge
• Occasionally abdominal cramps, period pains or backaches

It is important to note that most pregnant women experience some kind of discomfort, backache or abdominal pain during the initial stages of pregnancy. This does not mean that you are showing any signs of miscarriage, though.

These are normal pregnancy symptoms. If these symptoms are accompanied by some vaginal bleeding, however, then you should consider contacting your doctor.

As the name suggests, a threatened miscarriage does not necessarily mean that your pregnancy will end in pregnancy loss. Many women experience some vaginal bleeding during the first trimester and go on to deliver normally.

There are also women who have experienced the symptoms of a threatened miscarriage, but with proper care, have completed their pregnancies.

If your cervix remains closed during a threatened miscarriage, the chances of foetal survival are higher than if the cervix is opened.

Statistically, about 30% of threatened miscarriages end in pregnancy loss while the remaining 70% result in a live birth.

What is the Cause?

Unfortunately, the precise cause of a threatened miscarriage is rarely discovered. However, there can be various reasons for vaginal bleeding that may not even be related to miscarriage, including:

• infection, such as STDs and pelvic inflammatory disease
• hormonal changes
• endometriosis
• cervical inflammation caused by intercourse
• polyps
• cysts or uterine fibroids

Diagnosis of Miscarriage

If you experience any kind of bleeding during the first trimester, it is always better to inform your doctor about it. Most doctors may suggest waiting and watching the bleeding for a few days before drawing any conclusions.

In order to determine whether you are at risk of a miscarriage, your doctor will perform a pelvic exam to check the size and shape of your uterus.

Your cervix will also be checked to find out if it is open or closed. If it is found to have widened or effaced (thinned out), then a miscarriage is more likely. Depending on the stage of your pregnancy, the baby’s heartbeat may also be checked using a Doppler machine.

The most common and definite way to analyse the baby’s condition is by an ultrasound check up. This helps the doctor check the baby’s heartbeat, whether it is in the right position inside the uterus or if there is a chance of ectopic pregnancy.

It also provides an idea as to the development of the baby, if it is growing as expected during that particular stage of pregnancy.

Sometimes, heavy bleeding may also be caused by miscarrying one baby when you are expecting twins, triplets or higher order multiples.

During this time, the doctor may ask you to be admitted to the hospital in order to provide the surviving child with the proper care.

Treatment

Specifically stopping vaginal bleeding during pregnancy is unfortunately not possible. Therefore, a variety of treatments are used to reduce the risk of a miscarriage occurring.

Some doctors will take a wait and see approach so long as the baby appears to be healthy and your bleeding is minimal. Other women may be prescribed pelvic rest, which includes avoiding sex and not using tampons or douches for a specified amount of time. This will help a sensitive cervix from being damaged.

Reducing the amount of vigorous activity you perform is another treatment option. Though it once was common, full bed rest is unlikely to be prescribed nowadays as it has been shown to not have any effect on the outcome.

Another not so common treatment is the use of progesterone, which may help relax uterine muscles. However, because it can increase the risk of a partial miscarriage or cause problems in a pregnancy, progesterone creams are not typically prescribed.

Prevention

It is difficult to minimize the chances of a threatened miscarriage occurring. Maintaining regular prenatal appointments and following a healthy lifestyle will help ensure that you stay healthy throughout your pregnancy.

Additionally, seeing your doctor regularly throughout your pregnancy will help ensure that any health concerns you have are dealt with promptly.