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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

Although the actual cause of the miscarriage is frequently unclear, many miscarriages before 14 weeks occur because there is something wrong with the baby. Chronic illnesses, including diabetes, severe high blood pressure, kidney disease, lupus and underactive or overactive thyroid gland, are risk factors for miscarriage. Antenatal care is important because it screens for some of these diseases.

Inadequate ovarian hormone production is one of the most common causes of a miscarriage.

Acute infections, including rubella (German measles), CMV ( cytomegalovirus), mycoplasma ('walking' pneumonia) and other unusual germs, and severe emotional shock, can also cause miscarriage.

Diseases and abnormalities of the internal female organs can also cause miscarriage. Some examples are an abnormal womb, fibroids, poor muscle tone in the opening of the entrance of the womb, abnormal growth of the placenta (also called the afterbirth), and being pregnant with multiples.

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 closest hospital's accident and emergency department to be assessed.

A pregnant woman should go to hospital if she experiences the following symptoms:

  • 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
  • Severe vomiting

Threatened miscarriage diagnosis

The doctor or nurse in the accident and emergency department will ask many questions, such as the following:

  • How far along is your pregnancy?
  • When was your last normal period?
  • How many times have you been pregnant?
  • How many living children do you have?
  • How many miscarriages have you had?
  • Have you ever had an ectopic pregnancy?
  • Were you using any sort of birth control when you got pregnant this time?
  • Have you had any antenatal care?
  • Have you had an ultrasound yet to show that the pregnancy is in the right place?
  • What medical problems do you have?
  • What medications do you take every day?
  • What herbs or other products do you take every day?
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