The term "threat of miscarriage" mentioned in the doctor's conclusion always causes panic in future mums. The midwives hasten to reassure pregnant women that this is not a pathology and with proper literate therapy, it is possible to avoid interruption of the pregnancy.
What does the threat of termination of pregnancy mean?
The threat of termination of pregnancy is a combination of factors, pathological processes that negatively affect not the fetus, the process of gestation. According to statistics, 20% of all upcoming pregnancies end in miscarriage. In this case, interruption can occur at different gestation times. More often it is observed in the first weeks, in the first trimester.
If the threat of miscarriage occurs within 28 weeks of pregnancy, obstetricians talk about spontaneous abortion. When the probability of developing this pathology is observed at a later date, in the interval of 28-37 weeks, physicians use the term "threat of premature birth". This is due to the presence of the possibility of nursing a newborn, born after 28 weeks. In the case of a spontaneous abortion of a pregnancy on a short term, the death of an infant is inevitable.
Threat of abortion - reasons
The factors provoking the development of this pathology are diverse. In the course of diagnosis after the abortion, doctors do not always manage to determine the cause. This is explained by the multifactority, simultaneous presence of several reasons, in combination raising the risk of abortion. In considering this problem, doctors more often call the following reasons for the threat of miscarriage:
- Genetic pathology of the fetus. The development of anomalies in the structure of chromosomes, an increase in their number significantly increases the risk of abortion. Often, the threat is caused by mutations in the gene apparatus.
- Hyperandrogenia - increased content in the blood of male sex hormones. With pathology, there is a decrease in the concentration of estrogens and progesterone, which is responsible for the normal development of pregnancy.
- Dysfunction of the adrenal and thyroid gland - increase or decrease in the concentration of hormones synthesized by them.
- Rhesus-conflict is a pathology in which the Rh-negative mother carries a fetus, the blood of which is Rh-positive.
- Presence of abortions in the anamnesis.
- Spontaneous intake of medicines and herbs - hormonal agents, analgesics, medicinal herbs (tansy, nettles, St. John's Wort) can increase the risk of developing a threat of miscarriage.
- Injuries to the abdomen.
- Prolonged physical activity.
Separately it is necessary to note infectious diseases. In relation to the threat of miscarriage, they are divided into:
- specific - gonorrhea, chlamydia, trichomoniasis , toxoplasmosis;
- nonspecific - hepatitis, pneumonia, influenza, appendicitis, pyelonephritis.
Threat of miscarriage in the first trimester
The threat of early termination of pregnancy is often associated with an imbalance in the hormonal system. Often, especially in young women with the onset of the gestation process, there is a shortage of the hormone progesterone. This substance is responsible for normal implantation. Under its influence, the growth of cells of uterine myometrium increases, which collects the optimal thickness for implantation of the fetal egg. Progesterone insufficiency prevents the normal development of the endometrium, as a result of which the pregnancy is interrupted on a short term.
In second place among the causes leading to the threat of miscarriage in the first trimester, are chronic diseases of the reproductive system, sexual infections. Against the background of a decrease in immunity, which is observed at the beginning of pregnancy, favorable conditions are created for the transition of chronic, sluggish processes into an acute form. Among diseases that can disrupt the normal course of pregnancy:
- chlamydia ;
- gonorrhea;
- syphilis;
- genital herpes .
Threat of miscarriage in the second trimester
In most cases, the threat of termination of pregnancy in the second trimester is associated with a violation of the internal organs of the pregnant woman, and not the fetus. Often, interruption of gestation in the interval of 13-24 weeks occurs as a result of anemia of pregnant women. The disease is accompanied by a deficiency in the body of iron, which is part of hemoglobin. With the help of this substance, oxygen is transported to the organs and tissues of the fetus. Anemia can lead to an oxygen starvation of a small organism, which negatively affects intrauterine development - the threat of miscarriage.
Interruption of pregnancy in the middle of the term is possible and because of placenta previa. With this type of placement of the child's place, one of the edges is located close to the inner throat of the uterus. As a result, the risk of partial placental abruption increases, which can cause chronic hypoxia and fetal death. Also, the threat of miscarriage can be considered as a consequence of ischemic-cervical insufficiency. With this violation, there is a decrease in the elasticity of the uterine neck, which, experiencing great pressure from the baby's body, can be opened.
Threat of miscarriage in late pregnancy
The threat of termination of pregnancy in later periods is rare. According to the terminology used by physicians, it develops no later than 28 weeks of gestation. After this period obstetricians use the term "premature birth". This definition indicates that the infant that appeared at this time is viable. In later terms, the development of the complication proceeds according to one of the following scenarios:
- Threatening abortion - is characterized by an increase in the tone of the uterine musculature, a slight bleeding from the uterine cavity. With timely and skilled care, the fetus can be saved.
- Abortion in the course - a violation is accompanied by a placental abruption, the fetal expulsion from the uterine cavity. It is accompanied by cramping pains, heavy bleeding. It is impossible to save a pregnancy.
- Incomplete abortion - characterized by the release of part of the fetus or rupture of membranes. The fetus is removed by surgery.
Threat of miscarriage - symptoms
It is difficult to recognize the threat of interruption to a pregnant woman. On average, 10-15% of all cases of pathology are accompanied by latent or sluggish symptoms. The first thing that needs to be paid attention to a pregnant woman is the sudden appearance of bloody discharge from the vagina. At first it can be a few drops on your underwear. However, over time, symptoms increase. The woman also records other signs of a threat of miscarriage:
- feeling of heaviness, discomfort, aching pain in the lower abdomen;
- deterioration of general well-being;
- lowering blood pressure;
- nausea;
- vomiting.
When examined on a gynecological chair, the following is found:
- The uterus does not respond to the examination by increasing the tone;
- the outer sulcus is closed or slightly ajar;
- There is blood in the genital tract.
Allocations in case of threat of miscarriage
The threat of miscarriage in the early stages of pregnancy is always accompanied by the appearance of blood from the genital tract. At the initial stage, its volume is small, about the same as what is observed with menstruation. The color of the discharge can range from bright red to serous-bloody. According to the observations of doctors, in 12-13% of cases bloody discharge leads to the termination of pregnancy. With severe bleeding, there is a risk of developing uterine bleeding, which is accompanied by:
- headache;
- vomiting;
- lowering blood pressure;
- blanching of the skin;
- increased heart rate;
- loss of consciousness.
Pain in case of threat of miscarriage
The threat of termination of pregnancy, the symptoms of which are discussed above, is almost always accompanied by pain in the lower abdomen. Symptomatology is associated with an increase in the tone of uterine myometrium, which increases its contractility. This phenomenon is accompanied by strong painful, pulling character sensations (less often pulling or cramping). With the threat of miscarriage, the pain is localized mainly in the suprapubic region, it can give back to the lower back or the sacrum. The intensity of pain does not depend on the position of the body.
What to do in case of threat of miscarriage?
When a pregnant woman is diagnosed with a threat of miscarriage, the treatment begins immediately. Therapy is carried out in a hospital, while its basis is compliance with bed rest (in severe cases, a pregnant woman is forbidden to get out of bed). The risk of abortion causes anxiety and fear in a woman, so sedatives are prescribed for his elimination. Doctors advise to remain calm for as long as you need to think about the pleasant.
Clinical recommendations threat of abortion
That the threat of miscarriage at early stages did not lead to the termination of pregnancy, doctors recommend women to observe the following conditions:
- Limit exercise.
- More rest.
- Eliminate stress and anxiety.
- Abstain from sexual intercourse.
- Observe a low-calorie diet.
Tablets in case of threat of miscarriage
All drugs in the event of a miscarriage should be prescribed exclusively by a doctor. The specialist, taking into account the severity of the condition, the state of health of the pregnant woman, prescribes the medicines in the required dosage. Among the drugs used:
- antispasmodics (Papaverin, No-shpa, Drotaverin);
- gestagens (Dyufaston at the threat of miscarriage at early stages helps to eliminate pathology);
- glucocorticoids (Dexamethasone, Metipred);
- hemostatics (Dicinon, Vikasol, Ascorutin);
- vitamins (folic acid, vitamin K, E).
Morning in the threat of miscarriage is used not less often than other gestagens. In this case, doctors recommend using it in candles. Dosage and multiplicity are set individually, but in most cases, doctors adhere to the following treatment regimen:
- 1 suppository with a dosage of 200 mg per day;
- 2 candles per day with a dosage of 100 mg.
When injected with a threat of miscarriage
Treatment of the threat of abortion in the hospital involves the use of injectable forms of drugs. In this case, the same drugs as listed above are used, but in the form of solutions. Such a method of administration makes it possible to achieve the earliest possible onset of therapeutic effect. Among the drugs used in the form of injections:
- Magnesium sulphate ;
- Partusisten;
- Ritodrin;
- Alupent.
How to prevent a threat of miscarriage?
Preventive maintenance of an abortion should begin at a stage of planning of pregnancy. Before conception of a married couple it is necessary to undergo examination, to pass tests, to undergo a course of therapy in the detection of chronic diseases.
Preventive measures aimed at eliminating the threat of miscarriage include:
- timely registration for pregnancy;
- adherence to doctor's recommendations;
- rejection of bad habits;
- elimination of stressful situations;
- refusal from heavy physical exertion, sports training;
- normalization of the regime of the day.