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Treatment of threatened abortion
Last reviewed: 04.07.2025
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In case of a threatened abortion, there is a feeling of heaviness or slight nagging pain in the lower abdomen and sacral region; in case of a late abortion, there may be cramping pain. Bloody discharge is insignificant or absent. The cervix is not shortened, the internal os is closed, the tone of the uterus is increased. The size of the uterus corresponds to the gestational age, since the detachment of the ovum occurs in a small area.
Differential diagnosis of threatened abortion:
- Malignant or benign diseases of the cervix or vagina. During pregnancy, bloody discharge from the ectropion is possible. To exclude diseases of the cervix, a careful examination in mirrors is carried out, if necessary, a colposcopy or biopsy.
- Bloody discharge of the anovulatory cycle is often observed after a delay in menstruation. There are no symptoms of pregnancy, the beta-chorionic gonadotropin test is negative. Bimanual examination shows that the uterus is of normal size, not softened, the cervix is dense, not cyanotic. The anamnesis may include similar menstrual cycle disorders.
- Hydatidiform mole. There may be characteristic discharge in the form of bubbles. In 50% of patients, the uterus is larger than the expected gestation period. Characteristic picture on ultrasound, no fetal heartbeat.
- Ectopic pregnancy. Patients may complain of bloody discharge, bilateral or generalized pain, fainting (hypovolemia) is not uncommon, a feeling of pressure on the rectum or bladder. The beta-chorionic gonadotropin test is positive. Bimanual examination reveals pain when moving the cervix, the uterus is smaller than the expected pregnancy period, a thickened tube may be palpated, and bulging of the vaults is common.
To clarify the diagnosis and monitor the course of pregnancy, in addition to general clinical research methods, it is advisable to use the following tests:
- rectal temperature above 37°C without medication is a favorable sign (often persists for a long time during a non-developing pregnancy);
- human chorionic gonadotropin (hCG) level;
- Ultrasound.
Treatment of threatened abortion should be comprehensive: bed rest, sedatives, antispasmodics. In case of unclear genesis of miscarriage, specific therapy (hormonal treatment, immunocytotherapy) is inappropriate, non-drug and physiotherapeutic methods of treatment (acupuncture, electroanalgesia, analgesic transcutaneous stimulation, endonasal galvanization, etc.), antispasmodics, Magne-B6 can be used. In case of late threatened miscarriage, beta-mimetics and indomethacin are used for treatment.