Threatened Abortion

Introduction

A woman who is pregnant   who experiences cramping or bleeding   at any time should call her health care provider. A pregnant woman who experiences these symptoms but does not have a health care provider should go to her closest hospital's emergency department to be examined.

A pregnant woman should go to the hospital if she experiences the following symptoms:

• Heavy bleeding (soaking more than one pad per hour)
• Passing something that looks like tissue (Place this tissue in a container and take it with you to the hospital.)
• Severe cramping (like a menstrual period)
• Cramping or bleeding accompanied by fever
• Bleeding or abdominal pain   in a woman who has had a previous ectopic (tubal) pregnancy
• Vomiting   so severe she can't keep anything down

Self-Care at Home

If a woman is not sure if she is pregnant, a home pregnancy test will confirm or exclude pregnancy in most cases. If a woman knows she is pregnant and experiences cramps   or vaginal bleeding  , she should call her health care provider at once and follow the health care provider's instructions.

Follow-up

• Although rest will not prevent miscarriage, a woman may feel better if she avoids exerting herself.
• Do not douche or insert anything (including tampons) into the vagina.
• Do not have sex until symptoms have been completely gone for 1 week.

• Return to the emergency department in the following cases:
  • Acupuncture  Cramping worsens
  • Bleeding worsens (requiring more than 1 pad per hour)
  • Passage of tissue
  • Fever
  • Anything else alarming

Another blood test may be performed in 48-72 hours to check the hCG level. The rise or fall of this level is helpful in predicting if the pregnancy has ended. If the level is falling, the pregnancy may have ended.

A follow-up ultrasound may be performed.

Prevention

While there is no way to predict or prevent miscarriage in most cases, certain steps can be taken to improve the chance of a pregnancy continuing to term.

• Get prenatal care and follow the advice of your health care provider.
• Avoid alcohol, nicotine, and street drugs, especially cocaine.
• Avoid or reduce caffeine intake.
• Control high blood pressure   and diabetes  .
• Get treatment for infections.

Outlook

More than half of women who bleed during the first 12 weeks of pregnancy stop bleeding and have a healthy pregnancy. For the other half of these women, cramping and bleeding worsen and they eventually miscarry.

When a woman leaves the emergency room, she might not know if she will miscarry.