Threatened abortion is a threat of miscarriage in pregnancy before 20 weeks. This condition is characterized by vaginal bleeding but not accompanied by cervical dilation. Pregnancy in threatened abortion can be saved, but if not treated quickly, the sufferer can experience miscarriage.
Threatened abortion, or threatened abortion , occurs in 20–30% of all pregnancies. Some pregnancies with threatened abortion miscarry , while others can be saved.
Prompt treatment can prevent miscarriage due to threatened abortion. Therefore, a medical examination is needed as soon as possible if the prospective mother experiences symptoms of threatened abortion.
Causes of Threatened Abortion
- Having a bacterial or viral infection, such as rubella , while pregnant
- Having an injury to the stomach
- Having certain diseases that are not properly treated, such as diabetes or thyroid disease
- Suffering from uterine disorders, such as uterine polyps or uterine cysts
- Having a difference in blood type rhesus between the mother and fetus ( rhesus incompatibility )
- Taking certain medications, such as diclofenac or misoprostol
- Smoke
- Excessive consumption of alcoholic beverages
- Exposure to certain chemicals, such as heavy metals or cleaning solvents
- Being over 35 years old when pregnant
- Suffering from obesity
- Experiencing a lack of progesterone hormone levels, because this hormone plays a role in preparing and strengthening the uterine wall during pregnancy.
Symptoms of Threatened Abortion
Symptoms that may appear due to threatened abortion include:
- Vaginal bleeding in the first 20 weeks of pregnancy
- Stomach cramps
- Lower back pain
- Feeling of pressure in the waist
- Back pain
Back pain and abdominal cramps may be continuous or come and go. If the condition worsens, blood clots may come out of the vagina.
When to see a doctor
If you are pregnant and experience the symptoms mentioned above, immediately go to the hospital emergency room or the nearest health service. Immediate treatment by a doctor can avoid the risk of miscarriage.
Diagnosis of Threatened Abortion
The doctor will begin the diagnosis by asking questions about the patient’s symptoms and medical history. After that, the doctor will perform a physical examination, including a pelvic exam, to detect whether a miscarriage has occurred or not.
During a pelvic exam, the doctor will check for opening of the birth canal (cervix opening) or rupture of the water. The doctor will also perform a pregnancy ultrasound to check the heartbeat and development of the fetus.
The doctor may also perform further examinations, such as:
- Complete blood test , to check hemoglobin levels which can decrease due to bleeding, as well as to check blood type and rhesus in the mother and fetus.
- Urine test, to detect urinary tract infections
- Beta hCG test, to determine gestational age, and detect incomplete miscarriage or fetal death.
Treatment of Threatened Abortion
Treatment of threatened abortion aims to relieve symptoms and prevent complications. Some treatment methods that can be done are:
First Aid
As an initial step, the doctor will advise the patient to carry out self-care, such as:
- Do bed rest
- No sexual intercourse
- No exercise
- Do not use tampons
- Don’t travel far
Drugs
In addition to self-care at home, doctors can also prescribe medications. Medications that can be given include progesterone , such as dydrogesterone , to strengthen the uterine wall, and Rh immunoglobulin, to overcome rhesus incompatibility.
Complications of Threatened Abortion
If not treated immediately, threatened abortion can cause several complications, such as:
- Miscarriage
- Severe bleeding
- Infection of the endometrium (endometritis)
- Miscarriage accompanied by infection (septic abortion)
- Depression and anxiety disorders
Prevention of Threatened Abortion
Given that the cause is not yet known for certain, threatened abortion is difficult to prevent. However, the risk of this condition can be reduced by maintaining a healthy pregnancy. Some efforts that can be made are:
- Undergo a TORCH examination before planning a pregnancy.
- Treating bacterial or viral infections suffered before planning a pregnancy
- Taking folic acid supplements as recommended by your doctor
- Stop smoking or drinking alcohol
- Reduce consumption of caffeinated drinks
- Avoid exposure to chemicals
- Exercise at least 2 times a week
- Do not abuse narcotics
- Avoid foods that can harm the mother and fetus, such as raw foods .
In addition to the above, prospective mothers are also advised to always have pregnancy check-ups with a doctor so that the condition of the fetus can always be monitored. Prospective mothers who suffer from chronic diseases, such as diabetes, also need to treat their illnesses by taking medication and checking up with a doctor regularly.
Refences :
Parveen, R., et al. (2021). Oral versus Vaginal Micronized Progesterone for the Treatment of Threatened Miscarriage. Pakistan Journal of Medical Sciences, 37(3), pp. 628–632.
Deng, Y., et al. (2020). Baseline Levels of Serum Progesterone and the First Trimester Pregnancy Outcome in Women with Threatened Abortion: A Retrospective Cohort Study. BioMed Research International, 2020, pp. 1−8.
Zhou, J., et al. (2019). New Thoughts in Exploring the Pathogenesis, Diagnosis, and Treatment of Threatened Abortion. BioScience Trends, 13(3), pp. 284−285.
National Institutes of Health (2021). National Library of Medicine. Threatened Abortion.
Mayo Clinic (2021). Diseases & Conditions. Miscarriage.
Mount Sinai (2020). Health Library. HCG Bood Test – Quantitative.
Mount Sinai (2020). Health Library. Miscarriage - Threatened.
Drugs (2021). Threatened Miscarriage.
Healthline (2022). Threatened Abortion (Threatened Miscarriage).
MSD Manual (2020). Spontaneous Abortion.
Verywell Family (2021). Signs and Risks of a Threatened Miscarriage.