Does a threatened miscarriage require a uterine curettage?

Written by Zhang Lu
Obstetrics
Updated on September 18, 2024
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Threatened miscarriage, as the name suggests, refers to signs indicating a potential miscarriage. Whether a curettage is necessary in cases of threatened miscarriage mainly depends on the pregnancy outcome. For threatened miscarriage, treatment is chosen based on the patient's wishes. If the patient desires to continue the pregnancy and try to preserve it, medication can be used initially for conservation. However, if a woman experiencing threatened miscarriage does not wish to continue the pregnancy, she can opt for artificial intervention to induce the miscarriage. Miscarriage can be induced through oral medication or through a curettage procedure. Thus, curettage is not necessarily required for a threatened miscarriage, and even if the pregnancy is to be terminated, medication can be used as an alternative. Therefore, there is no inevitable connection between threatened miscarriage and curettage.

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Written by Zhang Lu
Obstetrics
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Can a threatened miscarriage have a transvaginal ultrasound?

Whether or not to perform a transvaginal ultrasound during a threatened miscarriage mainly depends on the symptoms of the threatened miscarriage. A threatened miscarriage refers to the signs of a potential miscarriage, with common symptoms including vaginal bleeding and severe abdominal pain. If there is significant abdominal pain, a transvaginal ultrasound can be performed to determine the position of the gestational sac, or an abdominal ultrasound can also be done. If there is vaginal bleeding, performing a transvaginal ultrasound in this case may aggravate stimulation to the uterus and can easily lead to vaginal inflammation. In such cases, an abdominal ultrasound is generally recommended. Therefore, a transvaginal ultrasound can be performed if there is only abdominal pain during a threatened miscarriage, but it should not be done if there is concurrent vaginal bleeding.

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Written by Zhang Lu
Obstetrics
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Is a threatened miscarriage the same as a biochemical pregnancy?

Threatened miscarriage and biochemical pregnancy are two important terms used to describe the state of pregnancy in early stages, but they are two completely different physiological states. First, threatened miscarriage refers to a situation where an intrauterine pregnancy has been confirmed and the gestational sac is unstable or affected by external stimuli, showing symptoms such as lower abdominal pain and spotting. These symptoms merely indicate signs of a possible miscarriage, and with timely treatment, it is possible to revert to a normal pregnancy. Second, a biochemical pregnancy is a type of natural miscarriage. It refers to early pregnancy where the HCG levels are relatively low, no clear gestational sac has formed, and upon re-examination, the HCG levels are found to decrease quickly, accompanied only by minimal vaginal bleeding.

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Written by Zhang Yin Xing
Obstetrics
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What are the symptoms of a threatened miscarriage?

The symptoms of threatened miscarriage primarily include a small amount of vaginal bleeding and mild lower abdominal pain or sacral pain. Threatened miscarriage refers to the occurrence of a small amount of vaginal bleeding before 28 weeks of pregnancy, often dark red in color, with no pregnancy tissue expelled. This may be accompanied by intermittent lower abdominal pain or back pain, or it may occur without any pain symptoms. During a gynecological examination, the cervix is closed, the membranes are intact, and the uterine size matches the gestational age. After rest and treatment, the symptoms may disappear and the pregnancy can continue. If the amount of vaginal bleeding increases or the lower abdominal pain worsens, accompanied by dilation of the cervix and expulsion or shedding of pregnancy tissue, it can progress to an inevitable miscarriage, which then requires prompt and active management to terminate the pregnancy.

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Written by Zhang Lu
Obstetrics
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What is the cause of nausea in threatened miscarriage?

Threatened miscarriage refers to signs of miscarriage during pregnancy, and some women with threatened miscarriage may experience nausea. This situation includes several reasons: First, threatened miscarriage is not the same as a natural miscarriage; women are still pregnant, hence early pregnancy reactions such as nausea are normal. If the nausea is mild, rest and observation are advisable. However, if severe, it is important to visit the hospital for an examination to rule out hyperemesis gravidarum. Second, some cases of threatened miscarriage are caused by gastrointestinal inflammation, such as acute gastritis causing uterine contractions, which then leads to threatened miscarriage. The nausea in these situations is due to acute gastritis, so the nausea is a symptom caused by the condition that leads to the threatened miscarriage, not a direct result of the threatened miscarriage itself.

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Written by Zhang Lu
Obstetrics
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Can a threatened miscarriage still preserve the pregnancy?

When threatened miscarriage occurs, attempts are generally made to carry out treatment to save the pregnancy. Whether the treatment can successfully save the pregnancy mainly depends on the severity of the symptoms, whether the treatment is timely, and the quality of the embryo itself. Firstly, if it is a mild threatened miscarriage, such as mild lower abdominal pain or light vaginal bleeding, in most cases, the pregnancy can be saved; if the symptoms are very severe, with heavy vaginal bleeding and intense abdominal pain, sometimes the pregnancy may not be saved. Secondly, when threatened miscarriage occurs, treatment should be selected based on the cause, including rest and medication. If the treatment is not timely, the pregnancy may not be saved. Thirdly, if the quality of the gestational sac is good, then even if a mild threatened miscarriage occurs, the pregnancy can often be saved; however, if the quality of the gestational sac is poor, then even with medication treatment, the pregnancy often cannot be saved.