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Threatened miscarriage

Any vaginal bleeding during early pregnancy may be considered a threatened miscarriage.

A miscarriage refers to a pregnancy that ends before the 24th week. A threatened miscarriage is when bleeding, and occasionally abdominal pain, occurs but the pregnancy continues.

Vaginal bleeding is relatively common during pregnancy among women who go on to have healthy births. However, bleeding from the vagina at any time in pregnancy can be a sign of problems and the midwife or GP should be contacted immediately.

The bleeding associated with threatened miscarriage is usually mild, and usually painless.

Threatened miscarriage and miscarriage causes

The actual cause of a miscarriage is often unknown.

Possible first trimester causes and risk factors include:

  • Chromosome and DNA problems with the foetus or baby
  • Problems with the placenta feeding the growing baby
  • Mother's age, with miscarriage more common over 40
  • Mother's obesity
  • Mum smoking
  • Drug abuse
  • Caffeine over 200mg a day
  • Alcohol use during pregnancy.

Possible second trimester causes and risk factors include:

 

When to seek medical care

A woman who is pregnant who experiences cramping or bleeding at any time should seek medical advice or go to the nearest hospital accident and emergency department to be assessed.

Reasons for concern include:

  • Heavy bleeding (soaking more than one pad per hour)
  • Passing something that looks like tissue (try to take this with you to hospital for examination)
  • Severe cramping, like a menstrual period
  • Cramping or bleeding accompanied by fever
  • Bleeding or abdominal pain in a woman who has had a previous ectopic pregnancy.

Threatened miscarriage diagnosis

The doctor or nurse in the accident and emergency department will ask about symptoms, medical history and possible risks.

Physical examination

The doctor or midwife may assess the opening of the entrance to the womb (called the cervical os) and, depending on the findings, will be able to tell you more accurately which of the stages of miscarriage you might be experiencing.

This is done during a pelvic examination where the health care professional puts gloved fingers in the patient's vagina and feels the abdomen with the other hand. He or she can feel whether the cervical os is open, how big the uterus may be, and whether there are any signs of infection or tubal pregnancy. He or she may perform a speculum examination using a metal or plastic device that helps examine the cervical os. The patient should not feel any pain during this part of the examination, although the procedure may be uncomfortable.

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