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Treatment of threatening abortion
Last reviewed: 20.11.2021
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When threatening abortion, a feeling of heaviness or slight pulling pains in the lower abdomen and the sacrum area is noted, with late abortion there may be pains of a cramping character. Bloody discharge is slight or absent. The cervix of the uterus is not shortened, the inner pharynx is closed, the tone of the uterus is elevated. The size of the uterus corresponds to the period of pregnancy, since the detachment of the fetal egg occurs in a small area.
Differential diagnosis of threatening abortion:
- Malignant or benign diseases of the cervix or vagina. In pregnancy, bleeding from ectropion is possible. To avoid diseases of the cervix, a careful examination is carried out in the mirrors, if necessary colposcopy or biopsy.
- Bloody discharge of the anovulatory cycle is often observed after a delay in menstruation. There are no symptoms of pregnancy, a test for beta-chorionic gonadotropin - negative. When bimanual examination - uterus of normal size, not softened, neck tight, not cyanotic. In the anamnesis there can be similar violations of the menstrual cycle.
- Bubble skidding. There may be characteristic discharge in the form of vesicles. In 50% of patients, the uterus is longer than the estimated gestational age. A characteristic picture with ultrasound, palpitation of the fetus is absent.
- Ectopic pregnancy. Patients can complain about spotting, pain bilateral or generalized, fainting conditions (hypovolemia), feeling of pressure on the rectum or bladder are not uncommon. The test for beta-chorionic gonadotropin is positive. In the bimanual examination, pain is noted when moving behind the cervix, the uterus is smaller than the expected pregnancy, a thickened tube can be palpated, and vaulting of the vaults is often possible.
To clarify the diagnosis and control over 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 drugs - a favorable sign (often lasts for a long time with undeveloped pregnancy);
- level of chorionic gonadotropin, TBG;
- Ultrasound.
Treatment of threatening abortion should be comprehensive: bed rest, sedatives, antispasmodics. If the origin of the miscarriage is not clear, specific therapy (hormonal treatment, immunocytotherapy) is not appropriate, non-pharmacological and physiotherapeutic methods of treatment can be used (acupuncture, electroanalgesia, analgesic percutaneous stimulation, endonasal galvanization, etc.), spasmolytics, magnesia-Vb. At a late threatening miscarriage for the use of beta-mimetics, indomethacin.