Threatened miscarriage can keep the pregnancy?

This is an automatically translated article.

The article is professionally consulted by Master, Doctor Nguyen Van Thanh - Obstetrician and Gynecologist - Department of Obstetrics and Gynecology - Vinmec Ha Long International Hospital
Miscarriage is a condition in which the fetus is expelled from the uterus when it is not able to survive in the environment. According to some studies, the probability of difficulty keeping the pregnancy is high if the pregnancy is > 40%. In cases of miscarriage, the gestational age is usually less than 20-22 weeks.

1. Miscarriage Types and Symptoms

Threatened miscarriage: There is bleeding and mild abdominal pain in early pregnancy. The fetus has not been expelled from the uterus. Examination reveals a closed cervix, which is more likely to preserve the pregnancy. Inevitable miscarriage: There is more bleeding and abdominal pain, the cervix begins to open, the ability to keep the pregnancy is more difficult. Incomplete miscarriage: When an ultrasound shows that part of the fetal tissue is still in the uterus and the rest has been expelled. Complete miscarriage: Ultrasound shows that all the fetal tissue has been expelled, there is no pregnancy in the uterus.

2. The role of ultrasound in diagnosing threatened miscarriage

Transvaginal ultrasound is very valuable in pregnant cases, especially those with symptoms of abnormal vaginal bleeding and abdominal pain in the lower abdomen.
Ultrasound is valuable in determining whether or not the existence of a fetus in the uterus, embryo status, number of fetuses, gestational age.
Ultrasound can detect signs of threatened miscarriage by recording hematoma (or dissection of the gestational sac). Hematoma in the uterus, under the placenta is a sign seen in patients with signs of threatened miscarriage as well as in asymptomatic cases.

3. The ability to stay pregnant when threatened with miscarriage

Within the first 20 weeks of pregnancy, 30-40% have abnormal vaginal bleeding with the following prognosis:
50% of these threatened miscarriage cases will lead to spontaneous abortion Vaginal bleeding lasts more than 3 days The risk of miscarriage will be even higher. The baby's heart usually completes by the 12th week. Therefore, having fetal heart activity 6 weeks before the threatened miscarriage, the risk of miscarriage is 7%; Eight weeks before a threatened miscarriage, the risk drops to 2%.

4. Treatment of threatened miscarriage

4.1 Uterine pain reliever or pain reliever Nifedipine: is the first choice in uterine contractions, if not in cases of contraindications. The drug is not used in women with low blood pressure, cardiovascular diseases such as heart failure, pre-eclampsia, amniotic fluid infection, fetal distress, antenatal bleeding, be careful when used concurrently with Salbutamol and drugs with active ingredients. portion of MgSo4.
The drug also has some unwanted effects such as headache, nausea, dizziness, hot flushes, heart palpitations, low blood pressure, a higher risk in people with heart failure, increased liver enzymes.
Salbutamol: As the 2nd choice, if it is not contraindicated. The drug is not used for women with heart failure, fetal heart failure, diabetes, thyroid disease. During the treatment period, if there are manifestations of chest pain, shortness of breath, respiratory rate > 30 times/minute, the infusion must be stopped; Salbutamol treatment should not be prolonged for more than 48 hours, only in special cases will be infused for another 24 hours.
The drug has some undesirable effects such as nausea, dizziness, hypotension, pulmonary edema, heart failure, hypokalemia, tremor, heart palpitations.
4.2 Corticosteroid Therapy Used to increase the production of surfactan, promote the growth of connective tissue, reduce respiratory distress in premature infants. Indicated for pregnant women from 28 weeks to the end of 34 weeks. Commonly used medications, such as betamethasone and dexamethasone, are administered intramuscularly.
Threat of miscarriage - miscarriage is a complication that no pregnant woman wants, so early recognition of signs and risks of miscarriage is something that pregnant women should know to prevent and coordinate with doctors to come up with. appropriate treatment regimen, ensuring safety for mother and baby. If there are unusual symptoms, pregnant women should be examined and consulted with a specialist.

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