What is Threatened Abortion or Threatened Miscarriage? In the first 20 weeks of pregnancy, nearly 1/3rd of women experience bleeding from the vagina and most of them do complete the entire term of pregnancy. However, in some mothers, the vaginal bleeding could be accompanied by abdominal cramping and pain in the region. These could indicate the possibility of a miscarriage, needing a pre-emptive abortion to protect the mother. Since it is a possibility, it is termed as a threatened abortion or a threatened miscarriage. Symptoms of Threatened Abortion Nearly all threatened abortions are proceded by bleeding occurring from the vagina, which majorly occurs in the initial 20 weeks of pregnancy. Other symptoms include, Cramping in the abdominal area that accompanies the bleeding is also observed. Pain in the lower back or the abdominal region, that could be dull but constant or even sharp spikes at times might also occur. Certain women observe some material resembling a clot or a tissue, that they pass from their vagina. PAIN IN LOWER BACK Causes of Threatened Abortion Some of the causes of a threatened abortion are, Certain anomalies present in the chromosomes of the embryo have been termed to be responsible in miscarriage at extremely initial pregnancy stages. Most women face threatened abortion due to a cervix that can’t hold the baby, fibroids of the uterus, inflamed villi, or even the presence of other diseases and conditions. Any swelling or inflammation in the interior parts of the uterus could trigger a miscarriage as well. Feverish chills, extreme fatigue, physical, mental, emotional stress, are all factors that could cause a threatened abortion. Repeat mothers face higher chances of a threatened miscarriage if they have had multiple children. Statistically, about 10% of women lose their pregnancy in extremely early stages. Diagnosis of Threatened Miscarriage In case of vaginal bleeding and abdominal pain, a nursing diagnosis for threatened abortion is the first step any pregnant mother should take to get clarity on the situation. Doctors start from the source of the problem and begin with the vaginal bleeding. They try to pinpoint the origin of the bleeding as well as check to see if the amniotic sac is intact. This examination usually involves the vagina, uterus and the cervix where the entire region of the reproductive system is properly checked for any anomalies. A threatened abortion ultrasound is the next step that is undertaken. This is to primarily understand the health of the baby and check if the heart is still beating properly and the growth is normal. In case the bleeding has been determined to emerge from the uterus, an ultrasound helps quantify it to take necessary actions. In the initial weeks of pregnancy, doctors prefer to undertake a transvaginal ultrasound using a probe inside the vagina, instead of the traditional abdomen-based ultrasound. This probe is inserted a few inches deep in the vagina and high-frequency sound waves are emitted. These are then sensed to create a vivid image of the internal foetal structure and look for anomalies. TRANSVAGINAL ULTRASOUND Since hormones can also be another culprit responsible for the condition, a blood test that includes a full blood count will be undertaken. These tests measure the HCG, or the human chorionic gonadotropin hormone, as well as progesterone. Both these hormones are produced to invoke and support pregnancy and are necessary to be present in the right amount. Treatment & Medication Bedrest is the primary requirement to recover from a threatened abortion. Any kind of physical activities, including sexual intercourse, should be strongly avoided. In case of the presence of conditions such as diabetes or thyroid related complications, the doctor might prescribe appropriate medication to treat them and support the pregnancy. In certain cases, the mother’s blood group might be Rh negative while the baby’s blood group might be Rh positive. This then causes the mother’s body to start creating antibodies and combat the format of the foetus’ blood. In such cases, doctors administer Rh immunoglobulins to keep this behaviour in check. If the tests reveal reduced levels of hormones, treatment of threatened abortion with progesterone injections might also be undertaken to bring them to the required amount. To stop the bleeding or any uterine contractions, haemostatic drugs or even tocolytic agent based medication might be given by your doctor to help mitigate the condition. Complications of Threatened Miscarriage With any health-related condition, and especially with pregnancy, there are strong chances of complications occurring even after taking the right actions in a threatened miscarriage. Since there is blood loss that takes place from the vagina, and the amount can sometimes be quite substantial, mothers could end up suffering from anaemia, which further deteriorates her health. In extreme conditions, doctors may even advise undertaking a blood transfusion in order to quickly bring the iron levels in the blood to a normal state. Due to illnesses, an infection might make its way to the foetus or even infect the region around it, leading to possible complications. The final condition might be such where a miscarriage does occur and the mother loses her foetus, or the foetus is not in a state to be carried to full term, and hence, requires to be aborted. This can be quite taxing for the mother physically as well as emotionally. 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