You may have heard the term ‘threatened miscarriage’ before but are unsure of what it means. What is a threatened miscarriage and what causes a threatened miscarriage? The answer is that it is exactly what it sounds like – a pregnancy that has a threat of miscarriage.
Threatened miscarriages are defined by bleeding and abdominal pain that does not result in miscarriage, but it can end up being so. About one in four women experience bleeding during their pregnancies, and about half of them end with successful pregnancies.
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The symptoms of a threatened miscarriage are few and far between, but easy to pinpoint. Abdominal cramps accompanied by bleeding is the primary symptom of a threatened miscarriage. Vaginal bleeding before 20 weeks of pregnancy is also a symptom.
Lower back pain occurs in some cases. Tissue or clot-like material may also pass from the vagina. Some complications that can happen with a threatened miscarriage are anemia, infections, or miscarriage itself.
A number of tests can be done to determine whether or not you are having a miscarriage. A threatened miscarriage ultrasound can tell if the embryo is still doing well. Blood samples are taken to determine how much blood has been lost and to test the white blood cell count, HCG, presence of a pregnancy, and progesterone level.
Causes of Threatened Miscarriage
Much like miscarriage itself, there is little known about the causes of threatened miscarriage. However, what is known can be used to treat and diagnose issues. Most issues with pregnancy are due to something being wrong with the fetus, but there can also be underlying factors that you can be tested for.
1. Abnormal Fetus
- Chromosome abnormalities
- Chromosomes do not line up properly due to a faulty set of chromosomes from a parent. When this happens, the pregnancy will end in miscarriage.
2. Abnormality in Mother
- Pelvic inflammatory disease
- Hormonal changes
- Inadequate hormone production from the ovaries is one of the most common causes.
- Diabetes and thyroid conditions have an effect on hormone levels and can cause pregnancy complications.
- This is a condition in which the uterine lining is located outside of the uterus and can cause severe pain and bleeding.
- Severe emotional shock
- If something happens to put you in such a state, it can be a danger to your growing fetus. Keeping yourself calm and handling whatever comes your way is a big part of parenthood, and you are just getting started.
- Inflammation of the cervix due to intercourse
- It is okay to have sex while you are pregnant but keep it safe.
- Cysts or uterine fibroids
Testing for Threatened Miscarriage
Lab tests and physical examinations are the primary methods of testing for a threatened miscarriage. Assessment of the womb opening will help your doctor figure out what stage of miscarriage you are experiencing. This will not be painful, just a little uncomfortable.
Pelvic exams are super helpful for this. By inserting gloved fingers and feeling the abdomen, the doctor can know things like the size of your uterus and whether or not there are signs of infection.
Blood tests are the other way to check the status of your pregnancy. As mentioned earlier, these blood tests look at multiple aspects of pregnancy. Ultrasounds are also used to exclude the possibility of an ectopic pregnancy.
Threatened Miscarriage Treatment
Diagnosing and treating threatened miscarriages can be difficult. Other than the tests they are going to do, there are some other factors your doctor will need to consider. Your doctor will probably ask you the following questions to help him get a better understanding of what is going on.
- How far along are you?
- When was the last normal period you had?
- How many living children do you have?
- Any medical problems?
- Have you had an ultrasound?
- What medications do you take?
- How many miscarriages have you had?
- How many times have you been pregnant?
- Have you ever had an ectopic pregnancy?
- Were you using birth control when you got pregnant?
- Have you had any antenatal care?
- What herbs or other products do you take every day?
There will also be lab tests to check your vitals and counts. Treatment includes bed rest, no douching or tampons, and no intercourse until the symptoms have been gone for one week. You may be told to go back home and have special instructions in the following circumstances: bleeding is not heavy, the cervical os is closed, laboratory tests are normal, and if the ultrasound reveals a healthy pregnancy.
Seek a follow up if your bleeding or cramping gets worse, you pass tissue, have a fever, or anything else concerns you. There are ways to help improve your chances of a successful pregnancy. Taking care of yourself and getting the care you need is pretty much the only thing you can do besides talking to your doctor.
Threatened Miscarriage Outcomes
Threatened miscarriages have a variety of outcomes. This shows that it is not always a drastic event when you have a threatened miscarriage. However, you should still take it seriously and make sure that everything is officially okay.
More than half of the women who bleed during their first 12 weeks of pregnancy have their bleeding stop and continue on with a healthy pregnancy. The other half will, unfortunately, end in miscarriage.
The chances of having a miscarriage are as follows:
- For women in their childbearing years – 10 to 25 percent
- Most healthy women – 20 to 25 percent chance
- For women under 35 – 15 percent chance
- For women who are 35 to 45 years old – 20 to 35 percent chance
- For women over 45 – up to 50 percent chance
- For women who have had previous miscarriages – 25 percent chance
Miscarriages occur in about 10 to 25 percent of all clinically recognized pregnancies
- Chemical pregnancies are confirmed by a blood test or ultrasound. These are the most accurate ways to confirm a pregnancy.
- These chemical pregnancies account for 50 to 75 percent of all miscarriages. The other type, biochemical, is not as accurate and should always be followed up with an official test.
- Most miscarriages occur during the first 13 weeks of pregnancy
- During the first 20 weeks of pregnancy, 20 to 30 percent of women have signs of miscarriage.
- About 30 percent of threatened miscarriages end in pregnancy loss while 70 percent will result in live birth and a healthy baby.
The symptoms and effects of threatened miscarriages differ from week to week. Here is an overview of the first few weeks and what can happen:
Threatened miscarriage at 4 weeks:
- The failure of implantation is the highest at this time since the embryo is vulnerable and has not attached to the placenta just yet.
- Between 22 percent and 75 percent of all healthy women will miscarry between three and four weeks.
- Lower back pain, cramping, spotting then bleeding, passing clots, and bleeding for an extended period of time, usually about 10 days, are all symptoms of week 4 miscarriage.
Threatened miscarriage at 5 weeks:
- There is a 10 percent chance of miscarriage at 5 weeks.
- Your pregnancy is still fragile, so watch out for these symptoms:
- Moderate to heavy bleeding, bad cramping, padding blood clots, heaviness in the abdomen, and pregnancy symptoms will cease.
Threatened miscarriage at 6 weeks:
- There is a five percent chance of miscarriage at this point.
- Moderate to heavy bleeding, lower back pain and severe cramping, clot passing, heaviness in the abdomen, extended bleeding for seven to 10 days, and the cessation of symptoms of pregnancy.
Threatened miscarriage at 7 weeks:
- There is also a five percent chance at this point in the pregnancy.
- Lower back pain, heavy to moderate bleeding, severe cramping, passing clots, heaviness in the abdomen, and extended bleeding for seven to 10 days. Losing the symptoms of pregnancy is a symptom as well.
Threatened miscarriages are pregnancies that are susceptible to being lost. Pregnancy is vulnerable, to begin with, and adding the factor of a new pregnancy can increase that vulnerability. There are ways to treat threatened miscarriages, but a good amount of them will end up being miscarried.
Having a threatened miscarriage does not mean you are going to lose the pregnancy. Having symptoms means that you should talk to your doctor. It may be nothing, but it is better to be safe than sorry. This is about a vulnerable embryo or fetus after all.
Keeping up with prenatal appointments and making sure that everything is okay is something you should often do. Your doctor will want to know how you are doing as well. You can always address any concerns or issues at one of these appointments, especially if you are uncertain you are having symptoms.