(Threatened Abortion; Threatened Pregnancy Loss)
Threatened miscarriage is bleeding from the vagina and symptoms that may mean a higher risk of miscarriage. It happens during the first trimester (13 weeks) of pregnancy. Not everyone who has bleeding in early pregnancy will miscarry.
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Possible causes of bleeding include:
- Embryo is implanting
- Irritation that may occur after sex
- The baby grows outside the uterus—ectopic pregnancy
- Molar pregnancy—a rare growth in the uterus
Things that may increase a the risk of threatened miscarriage are:
- Certain medicines
- Older age
The main symptom is bleeding during the first 13 weeks of pregnancy. Bleeding may be light or heavy. There may also be cramping.
The doctor will ask about symptoms and past health. A physical exam will be done. Tests may be done to look for a cause. They may include:
- Fetal heart monitoring
- Blood tests
Ultrasound and blood tests may need to be done again after a week or two to check on the pregnancy.
For many women, no treatment is needed. If needed, treatment may include:
- Medicine to treat some causes. This may include progesterone, a hormone that supports a pregnancy.
- Rho immune globulin for women with Rh-negative blood. This can stop the body from making antibodies against the fetus' blood.
It is not always possible to prevent threatened miscarriage. Prenatal care may help find and treat problems early.
- Bleeding during pregnancy. American Pregnancy Association website. Available at: http://americanpregnancy.org/pregnancy-complications/bleeding-during-pregnancy.
- Early pregnancy bleeding. EBSCO DynaMed website. Available at: https://www.dynamed.com/approach-to/early-pregnancy-bleeding.
- Hendriks, E., MacNaughton, H., et al. First trimester bleeding: evaluation and management. American Family Physician, 2019; 99(3): 166-174.
- Wahabi, H.A., Fayed, A.A., et al. Progestogen for treating threatened miscarriage. Cochrane Database Syst Rev, 2018; 8: CD005943.
- Beverly Siegal, MD, FACOG
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