Threatened Abortion

INTRODUCTION:

  • A clinical entity where the process of abortion has started, but has not progressed to a state where recovery is impossible.
  • The clinical diagnosis of threatened abortion is presumed when a bloody vaginal discharge appears through a closed cervical os during the first half of pregnancy.
  • Threatened Abortion is the most common complication in the first half of pregnancy.
  • Its incidence varies between 20-25%.
  • Miscarriage is 2.6 times as likely
  • 17% of cases are expected to present complications later in pregnancy.

ETIOLOGY:

  • Embryonic abnormalities
  • Maternal factors
  • Anatomic factors
  • Endocrine factors
  • Infectious factors
  • Immunologic factors

CLINICAL FEATURES:

  • The pregnant patient complains of :


  1. Bleeding per vaginum:The main reasons for vaginal bleeding in early pregnancy are subchorionichaemorrhage, subchorionic haematoma and rupture of a marginal placental sinus.
  2. Pain


  • Ectopic pregnancy differs from threatened abortion by Manifests at an early age
  • In threatened abortion, the size of uterus Corresponds to duration of amenorrhea

INVESTIGATION:

  • Blood


  1. Beta HCG
  2. CBC
  3. Pregnancy test
  4. DLC


  • Urine
  • Pelvic examination
  • Ultrasonography:check the baby's development, heart beat, and amount of bleeding
  • A negative pregnancy test excludes the diagnosis of Threatened abortion

COMPLICATIONS:

  • These fetuses are at increased risk for intrauterine growth retardation, preterm delivery, low birthweight, and perinatal death.
  • Maternal risks include antepartum hemorrhage, manual removal of the placenta, and cesarean delivery.

MANAGEMENT:

  • Bed rest
  • Paracetamol
  • Progesterone therapy
  • hCG therapy
  • Tocolytic agents
  • Mifepristone is not used in Threatened abortion
  • Antibiotics along with other measures are used to prevent and treat preterm labour, especially in the setting of chorioamnionitis which occur in case of ruptured membrane.

Exam Question

  • Mifepristone is not used in Threatened abortion
  • Ectopic pregnancy differs from threatened abortion by Manifests at an
  • early age
  • A lady presented with features of threatened abortion at 32 weeks of pregnancy should be given Antibiotics along with other measures are used to prevent and treat preterm labour, especially in the setting of chorioamnionitis which occur in case of ruptured membrane.
  • A negative pregnancy test excludes the diagnosis of Threatened abortion
  • In threatened abortion, the size of uterus Corresponds to duration of amenorrhea
  • The clinical diagnosis of threatened abortion is presumed when a bloody vaginal discharge appears through a closed cervical os during First half of pregnancy
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