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Threatened miscarriage - Symptoms, diagnosis and treatment

Pregnancy By Bhadra Kamalasanan , Onlymyhealth editorial team / Jul 10, 2015
Threatened miscarriage - Symptoms, diagnosis and treatment

Vaginal bleeding and abdominal pain are the two prominent signs of threatened miscarriage. If a woman experiences these during pregnancy, she needs to get herself checked.

Pregnancy is a time to rejoice for the family of the expectant mother, but for the mother, it is also a time when she has to take special care of herself. The first three months of pregnancy are especially the most important phase in a pregnant woman’s life because she is highly likely to miscarry.

Threatened miscarriage is when a woman experiences all the signs of miscarriage such as vaginal bleeding, spotting, discharge or blood stains and period pain or backaches, but does not necessarily have miscarriage. While a woman, upon spotting blood in the urine may panic thinking she is miscarrying, her doctor may upon examination clear that her baby is doing just fine.

Miscarriage threat

Threatened miscarriage is one of the most common complications that a woman goes through when she is pregnant. The British Medical Journal states that a miscarriage is about 2.6 times likely and 17% of the total cases of pregnancy are expected to present some sort of complications later in the pregnancy. While gynecologists and general practitioners often have patients coming to them with the condition, because only little is known about treating it, the management of this type of miscarriage is rather empirical.


Vaginal bleeding and abdominal pain are the two prominent signs of threatened miscarriage. If a woman experiences these during pregnancy, she needs to get herself checked.

According to the book, Maternal and Child Health Nursing: Care of the Childbearing and Childrearing Family, the symptoms of threatened miscarriage:

  • Starts off with a scant and usually bright red vaginal bleeding.     
  • While she notices the slight bleeding, she may also experience slight cramping, though no cervical dilatation will be observed on vaginal examination by the doctor. The Miscarriage Association recommends that women going through heavy bleeding with or without spots, must call the doctor immediately for help.


An abnormal growth of the foetus is a major cause of miscarriages during the first trimester of pregnancy. Problems in the genes cause the foetus to grow abnormally and are found in more than half of the miscarried fetuses. The risk of a woman having defective genes increases with her age. Miscarriage that happens during the fourth through the sixth month of pregnancy is often found to be related to abnormality in the mother instead of the foetus.

Some of these complications in the mother that may cause threatened miscarriage include:

  • Chronic illnesses like diabetes, high blood pressure, frequent miscarriages, underactive or overactive thyroid gland. Prenatal care is therefore, important because it screens the woman for these diseases and gives a green signal when the woman is found to be complications-free and healthy to conceive.
  • Inadequate production of ovarian hormone. This is one of the most common causes of a miscarriage.
  • Acute infections such as German measles, mycoplasma, severe emotional shock.
  • Miscellaneous factors such as using certain drugs, drinking excessive caffeine, tobacco and cocaine.
  • Abnormality of the internal female organs such as an abnormal woman,  poor muscle tone in the entrance of the womb, an abnormal growth of the placenta, fibroids and  being pregnant with multiples.

Miscarriage threat

What happens when a Threatened Miscarriage is suspected?

When a woman complains of spotting and visits a doctor, she may have to go through abdominal or vaginal ultrasound to check the development of the baby and the amount of bleeding. The doctor may further conduct a pelvic exam to check the cervix.

The doctor may also recommend the following blood tests if the cause for threatened miscarriage is not found yet:

  • Complete blood count to determine the amount of blood that has been lost.
  • Beta HCG test for over a period of days or even weeks to ensure that the pregnancy is still continuing.
  • Pregnancy test to confirm that you are pregnant and that the spotting is not a sign of menstruation that is yet to start.
  • Test to check your progesterone level, which is an important hormone needed during pregnancy.
  • White blood count with differential to rule out any infection that the woman may have contracted or is likely to contract.

In order to treat this condition, cervical os, i.e, mouth of the womb is closed. A pelvic exam is conducted to determine if cervical os is open. In this condition, womb and fallopian tubes may become tender. On the brink of miscarriage, bleeding becomes heavier, abdominal pain increases and body starts to cramp.


According to the book, Threatened Miscarriage, doctors may be able to diagnose it by:

  • Determining that the patient complaining of threatened miscarriage is pregnant.
  • Determining that the bleeding is coming from the uterus.
  • Deciding that if the uterine contractions are slight, the cervix is not dilated.


After a woman has got herself checked by a doctor and the cause of threatened miscarriage is found to be normal, she may be asked to:

  • Avoid participating in strenuous activities for at least 24 to 48 hours. Complete bed rest, in most cases, may not always be suggested because the blood is only pooling vaginally and a woman stops taking bed rest, the collection of vaginal blood will drain out and the woman will experience bleeding again.
  • Women suffering from threatened miscarriage must find a sympathetic partner to talk about their problems with. If you know someone who is going through a phase of vaginal bleeding and is likely to suffer from miscarriage, telling him that forgetting to pop an iron pill, running a flight of stairs, etc can help minimise the guilt.

After Treatment

Care of the Childbearing and Childrearing Family states that once the woman has taken enough rest or reduced her activity levels, the vaginal bleeding is likely to stop within 24 to 48 hours. Once the bleeding stops, the woman can resume normal activities. It has been estimated that 50% of women continue their pregnancy after the treatment of threatened miscarriage and others, who ignore tend to suffer from imminent miscarriage, which confirms the occurrence of miscarriage.


Threatened miscarriage does not always have to be a sure sign of miscarriage. It is important for pregnant women to know that slight spotting is natural in the first trimester, but if they observe that the bleeding is way more than what it should be, immediate medical help must be sought.

Image source: Getty Image

Read more articles on Miscarriage.




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