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Alternative Names Return to topThreatened miscarriage; Threatened spontaneous abortion; Abortion - threatened; Threatened abortion
Definition Return to top
A threatened miscarriage is a condition that suggests a miscarriage might take place before the 20th week of pregnancy.
Causes Return to top
A small number of pregnant women have some vaginal bleeding, with or without abdominal cramps, during the first trimester of pregnancy. When the symptoms indicate a miscarriage is possible, the condition is called a "threatened abortion." (This refers to a naturally occurring event, not medical abortions or surgical abortions.)
Miscarriage occurs in just a small percentage of women who have vaginal bleeding during pregnancy.
For more information, see: Miscarriage
Symptoms Return to top
Symptoms of a threatened miscarriage include:
Note: During an actual miscarriage, low back pain or abdominal pain (dull to sharp, constant to intermittent) typically occurs, and tissue or clot-like material may pass from the vagina.
Exams and Tests Return to top
Abdominal or vaginal ultrasound may be done to check the baby's development, heart beat, and amount of bleeding. A pelvic exam will be done to check the cervix.
The following blood tests may be performed:
Treatment Return to top
You may be told to avoid or restrict some forms of activity, or you may need complete bed rest. Not having sexual intercourse is usually recommended until the warning signs have disappeared.
The use of progesterone is controversial. It might relax smooth muscles, including the muscles of the uterus. However, it also might increase the risk of an incomplete abortion or an abnormal pregnancy. Unless there is a luteal phase defect, progesterone should not be used.
Outlook (Prognosis) Return to top
Many women with threatened miscarriage go on to have a normal pregnancy.
Possible Complications Return to top
When to Contact a Medical Professional Return to top
If you know you are (or are likely to be) pregnant and you have any symptoms of threatened miscarriage, contact your prenatal health care provider immediately.
Prevention Return to top
Some studies show that women who get prenatal care have better pregnancy outcomes, for themselves and their babies. Early and complete prenatal care reduces the risk of miscarriage.
It is better to find and treat health problems before you get pregnant than to wait until you're already pregnant. Many miscarriages that are caused by body-wide (systemic) diseases that can be prevented by detecting and treating the disease before becoming pregnant.
Miscarriages are less likely if you receive early, comprehensive prenatal care and avoid environmental hazards such as x-rays, drugs and alcohol, high levels of caffeine, and infectious diseases.
References Return to top
Katz VL. Spontaneous and recurrent abortion: etiology, diagnosis, treatment. In: Katz VL, Lentz GM, Lobo RA, Gershenson DM, eds. Comprehensive Gynecology. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2007:chap 16.
Simpson JL, Jauniaux ERM. Pregnancy loss. In: Gabbe SG, Niebyl JR, Simpson JL, eds. Obstetrics: Normal and Problem Pregnancies. 5th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2007:chap 24.
Laurino MY, Bennett RL, Saraiya DS, et al. Genetic evaluation and counseling of couples with recurrent miscarriage: Recommendations of the National Society of Genetic Counselors. J Genet Couns. June 2005;14(3).Update Date: 2/3/2009 Updated by: Linda Vorvick, MD, Family Physician, Seattle Site Coordinator, Lecturer, Pathophysiology, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.