The threat of abortion is a fairly common diagnosis. Hearing it from doctors, do not panic. A threat is not yet a miscarriage, and modern doctors know many ways to eliminate the problem that has arisen. But future mothers need to know what it is, the causes of this condition and treatment. What is the threat of miscarriage

A miscarriage is a spontaneous termination of pregnancy. There are two types of miscarriages:

Preclinical spontaneous abortion or biochemical pregnancy is a diagnosis that is made when the embryo itself was not detected due to a short period, but the level of hCG in the blood and urine was already rising.
Spontaneous abortion (miscarriage) is a pathological termination of a diagnosed pregnancy that occurred earlier than 20 obstetric weeks (18 weeks after conception).
If the loss of a child occurs after 20–22 weeks, it is called preterm birth.

It should be noted that in modern obstetrics there is no diagnosis of "threatened miscarriage", this concept is outdated. Any pregnant woman is at risk of losing a child, and doctors can really assess the likelihood of miscarriage. But the theoretical possibility of a miscarriage is not a disease or a diagnosis. Moreover, according to experts, every fifth pregnancy fails in the early stages, even before the onset of the delay. In this case, a woman does not notice changes in her condition and perceives bleeding as another menstruation.

When doctors talk about the threat of miscarriage, they mean a high probability of abortion. But the risk is not treated, it is necessary to determine the cause of miscarriage and decide on the need to save the embryo. In most cases, miscarriage is biologically feasible, so no maintenance therapy is needed.

It is very difficult to stop a miscarriage that has begun, so we must try to prevent it. The main causes of fetal loss are:

Genetic disorders in the fetus. Approximately 75% of pregnancies are terminated precisely because of a defective conception. Thus, the woman's body gets rid of a non-viable embryo, so there is no need to stop such a miscarriage.
Violation of the hormonal background. Lack of progesterone can lead to abortion. This does not happen often, and such a miscarriage can be easily stopped by taking hormonal drugs. If the reason is an excess of male sex hormones or those produced by the adrenal cortex and the thyroid gland, then the treatment will be more difficult and less effective.
Rhesus conflict. If a woman has a negative Rh blood factor, and the fetus has inherited a positive one from the father, then the mother's body can perceive the fetus as a foreign body and try to get rid of it.
Rhesus conflict
Rh-conflict of the fetus and mother

Infectious diseases in women. Cytomegalovirus, herpes, rubella and many other diseases can cause spontaneous abortion.
Chronic diseases of a woman and weak immunity. If the expectant mother is constantly sick, her body can get rid of the fetus, since pregnancy is a threat to life.
A history of abortion. Termination of pregnancy is a complex and dangerous operation that can permanently disrupt the normal functioning of the uterus, ovaries, adrenal cortex and other organs. Often this leads to infertility.
Taking medicines and certain herbs. Many drugs are teratogenic or abortive. If a woman unknowingly takes such a remedy, it can adversely affect the course of pregnancy. Contrary to popular belief, herbal treatment is not safer, even the familiar nettle, tansy and St. John's wort can cause an increase in uterine tone and spontaneous abortion.
Strong stress. Fear, grief, or even a banal family quarrel can trigger uterine contractions and miscarriage.
Heavy physical activity. Approximately 5% of pregnancies are terminated due to the fact that the woman lifted something heavy or was very tired.
Falls and injuries. They lead to miscarriages in the early stages very rarely, since the fetus is located deep in the body and is protected by water.
Overheat. Even just taking a hot bath can lead to an increase in temperature in a woman, which is fraught with abortion or impaired fetal development.
Bad habits. Taking drugs, alcohol, smoking, and even just drinking coffee can cause disturbances in the development of the embryo, up to and including death.
Hormone levels on different days of the menstrual cycle
Low levels of progesterone in the luteal phase is one of the causes of miscarriage

Symptoms and signs

The threat of miscarriage in the early stages is rarely manifested by any symptoms. If they are, then they differ little from the usual signs. pregnancy. Discomfort in the lower abdomen is quite common, as is a feeling of tension. Blood smearing is also not uncommon during implantation of the fetal egg and for some time after it.

The future mother herself cannot determine the threat of a miscarriage, but a doctor can do this. Firstly, he can study the woman's history and her state of health at the moment, which will make it possible to make some predictions. If the risk of miscarriage is high, your doctor may order regular blood tests to monitor your progesterone and hCG levels. Снижение их количества свидетельствует о возможном прерывании pregnancy.

Many women confuse implantation bleeding with threatened miscarriage. A small amount of spotting about a week after conception is normal.

Often, the threat of miscarriage is diagnosed by ultrasound. It is not right. First, the safety of ultrasound for the fetus in the early stages has not been proven. Secondly, exposure to high-frequency sounds can provoke uterine hypertonicity. Некоторые специалисты утверждают, что такая диагностика сама по себе может вызывать угрозу прерывания pregnancy.

Ways to prevent

Лучшая профилактика угрозы выкидыша на ранних сроках – осознанное планирование pregnancy. If a woman undergoes a medical examination in advance and makes sure that everything is fine with her health, this will significantly reduce the risks of interruption. It is also very important to give up bad habits and uncontrolled medication in time.

Separately, it is worth remembering about overdiagnosis. Nowadays, this is a very common problem: illiterate or unscrupulous doctors, using all the achievements of modern medical science, even find diseases in a woman that do not carry any risks for pregnancy. And then they are taken to treat, excluding the very possibility of conception. For example, the danger of latent infections is greatly exaggerated. Asymptomatic carriage in most cases does not threaten anything, and by forcing a woman to take antibiotics, doctors do not allow her to become pregnant until the end of therapy.

What to do and how to be treated?

The threat of miscarriage, especially at an early stage, is not a reason to panic and immediately begin conservation therapy. As we have already said, most cases, pregnancy is terminated due to fetal chromosomal abnormalities that are incompatible with life. Too actively maintaining such a defective conception will only delay the death of the embryo and make the abortion more painful, both physically and psychologically. Лечение оправдано только в тех случаях, когда беременность прерывается из-за нарушений гормонального фона или Rhesus conflictа.

Medical treatment

Preservation therapy is a painful topic of domestic gynecology. The fact is that the mechanisms of conception and pregnancy are very complex, and modern science does not yet know all the subtleties. Any intervention in this process is carried out almost blindly, therefore, in most developed countries of the world, with the threat of miscarriage in the early stages, expectant tactics are recommended.

Most progesterone preparations have such a low concentration of the active substance that they act more like a placebo.

In such a situation, domestic doctors try with all their might to maintain the pregnancy and often take many unnecessary and meaningless steps, grossly interfering with the functioning of the body. Worst of all, there is no evidence-based conservation therapy.

Progesterone (Dufaston, Utrozhestan, Endometrin) are hormonal drugs designed to compensate for the insufficiency of the luteal phase. Every month after ovulation, a special endocrine organ, the corpus luteum, is formed in the follicle in place of the egg that came out of it. It functions until the end of the cycle and the beginning of menstruation. The task of this organ is the production of progesterone, which prepares the uterine epithelium for implantation and maintains it in this state. After implantation of the fetal egg, it begins to produce hCG, which stimulates the corpus luteum to increase the production of this hormone. If fertilization does not occur, then gradually the level of progesterone drops, the inner layers of the endometrium exfoliate and menstrual bleeding begins. But for some unknown reason, some women experience a hormonal imbalance, and the increase in progesterone levels does not occur even after implantation. This threatens with detachment of the endometrium along with the fetal egg. And only in such cases is the use of tablets such as Duphaston, Utrozhestan and other similar drugs that help avoid rejection justified. fetus.
Papaverine, magnesia and other antispasmodics are not indicated for the threat of miscarriage, since the muscles of the uterus in the early stages are insensitive to them. They can affect the uterus only for long periods, when attempts begin during premature birth. Their widespread use in domestic hospitals at the very beginning of pregnancy is explained by their low cost and relative safety. Non-drug therapy

Sometimes, with the threat of abortion at an early stage, women are recommended electroanalgesia, electrorelaxation of the uterus, acupuncture, magnesium electrophoresis. These are methods that have nothing to do with evidence-based medicine. Their outcome is unpredictable, and safety and efficacy have not been studied.

The appointment of progesterone until the moment of fertilization makes it impossible to ovulate, and hence conception.

The only thing that can be recommended to a woman in this condition is rest and peace. You need to take sick leave at work, lie more and try to tune in to the