What should be done for a threatened miscarriage?

Written by Zhang Lu
Obstetrics
Updated on February 17, 2025
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Threatened miscarriage, as the name suggests, is a precursor to miscarriage, typically manifesting in several ways: first, a feeling of heaviness or pain in the lower abdomen; second, vaginal bleeding. The presence of these two symptoms often indicates signs of a miscarriage. Regarding the management of threatened miscarriage, whether to proceed with treatment to preserve the pregnancy primarily depends on the severity of the condition and the value of preserving the pregnancy. First, for minor cases of threatened miscarriage, if there is only slight bleeding and mild abdominal pain, medication can be used to inhibit uterine contractions and reduce bleeding. Second, if there is significant vaginal bleeding and severe abdominal pain, and if the embryo has already been confirmed to have ceased developing, preserving the pregnancy is generally not recommended. It is advised to terminate the pregnancy promptly or let it proceed naturally. (Medication should be used under the guidance of a doctor.)

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Written by Zhang Lu
Obstetrics
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Does a threatened miscarriage require a uterine curettage?

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 Du Rui Xia
Obstetrics
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Early symptoms of threatened miscarriage

Premature birth refers to the condition where delivery occurs after the pregnancy has reached 28 weeks but before completing 37 weeks. Premature infants have a very high mortality rate. If a woman experiences prolonged back pain and a hardening of the lower abdomen during this time, it is due to contractions of the uterus. There can also be vaginal discharge of fluids, indicating early breaking of waters. Increased vaginal discharge, sometimes with traces of blood, might also indicate imminent premature birth; medical check-ups and treatment should be sought immediately.

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

Threatened miscarriage refers to a small amount of vaginal bleeding occurring before 28 weeks of pregnancy. Usually, the amount of bleeding does not exceed that of a normal menstrual period, and the blood may be dark red or appear as bloody vaginal discharge. The color of the bleeding is not significant. No pregnancy tissue is expelled initially, and this may be followed by episodic lower abdominal pain or back pain, although these symptoms may not occur. During a gynecological examination, the cervix is closed, the membranes are intact, and the size of the uterus corresponds to the gestational age. After rest and treatment, the symptoms may disappear, and the pregnancy can continue. If the amount of vaginal bleeding increases or lower abdominal pain intensifies, accompanied by the expulsion of pregnancy tissue, it progresses to inevitable miscarriage. Inevitable miscarriage refers to a miscarriage that cannot be avoided. Based on the symptoms of a threatened miscarriage, the amount of vaginal bleeding increases, and episodic lower abdominal pain intensifies, possibly accompanied by vaginal fluid discharge. During a gynecological examination for inevitable miscarriage, the cervix is dilated, and embryonic tissue or the amniotic sac can be seen obstructing the cervical opening.

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Written by Zhang Lu
Obstetrics
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Can threatened miscarriage be treated with medical abortion?

Threatened miscarriage only indicates signs of a potential miscarriage and does not necessarily result in a spontaneous miscarriage. During a threatened miscarriage, medication can be used to preserve the embryo. If one does not wish to continue the pregnancy upon signs of a threatened miscarriage, intervention can be managed like a normal miscarriage. In early pregnancy, if one chooses to have an abortion, there are two methods available: medical abortion and surgical abortion, which are not significantly different from each other. For the majority of typical women, medical abortion is an option during a threatened miscarriage, though it is notably painful and can be prolonged. Patients must be clearly informed about the specific procedures and drawbacks. Surgical abortion, on the other hand, tends to be simpler and less painful.

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Written by Zhang Lu
Obstetrics
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What are some medications for threatened miscarriage to stabilize the pregnancy?

When threatened miscarriage occurs, it is necessary to use medications to sustain the pregnancy. Commonly used medications include the following types: The first type is progesterone medications, which have the effects of stabilizing the uterus and suppressing the immune system; the second type is estrogen medications, which can promote the proliferation of the endometrium, providing a favorable environment for the implantation and growth of the gestational sac; third, traditional Chinese medicine formulations, which also have the effects of stabilizing the uterus, promoting the development of the gestational sac, and reducing bleeding. In addition, it is necessary to conduct examinations based on the symptoms of threatened miscarriage to determine if there are any abnormalities in coagulation indicators. If the threatened miscarriage is caused by abnormal coagulation indicators, anticoagulant medications can be used for treatment.