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Miscarriage: what is it and symptoms of threatened abortion

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Conception is an extremely complex process in which every mechanism from ovulation, through fertilization, division and implantation of the embryo, has to occur perfectly. If any of them fail, the pregnancy will most likely fail.

It is believed that in one of every five pregnancies there is some abnormality during this complex process, ending in a natural abortion or spontaneous abortion . There are some symptoms that are usually related to the termination of pregnancy , signs that may indicate a threatened abortion.

Blood loss

Usually, the main symptom of miscarriage is bleeding or vaginal bleeding . However, it must be borne in mind that many women suffer blood loss and it is not always due to a threatened abortion.

Blood loss may be due to the appearance of an intrauterine hematoma, one of the most common causes of bleeding in the first trimester, or to implantation bleeding, a slight loss of pink or dark color that occurs when the embryo implants in the maternal uterus.

Vaginal bleeding can also be a symptom of ectopic pregnancy, one of the kinds of miscarriage. It is a pregnancy that occurs outside the uterus, which of course does not prosper. Brown vaginal leaks or light bleeding may occur several days or weeks before the pain, although these leaks will not occur if the tube is not ruptured. The pain is very intense, with extreme sensitivity, especially on one side in the lower abdomen.

Another variant of natural or spontaneous abortion is anembryonic pregnancy or pregnancy with an empty egg. It is the product of a fertilized egg that implants in the uterus, the gestational sac develops normally, but there is no embryo. Naturally, the pregnancy does not prosper and blood loss also occurs.

Intermittent brownish losses or vaginal bleeding can be a symptom of molar pregnancy, another variant of miscarriage, the result of abnormal fertilization of the ovum that produces a deformed growth of the placenta.

It should be considered as an alarm signal if the losses have the following characteristics :

  • If vaginal bleeding is heavier than normal period bleeding.

  • If vaginal bleeding exceeds a thick pad, or more than a pad within an hour.

  • If the bleeding is accompanied by clots.

In case of blood loss during the first trimester of pregnancy, it is necessary to go immediately to the doctor to assess the situation. A metrorrhagia (vaginal bleeding not coming from the menstrual cycle) in the first trimester of pregnancy is a threat of abortion until proven otherwise .

Abdominal pain

Bleeding is not always accompanied by pain. Usually, bleeding occurs first, followed by severe abdominal pain. However, there are times when colic without bleeding can occur, as in the case of ectopic pregnancy.

Abdominal pain can present in the form of constant or intermittent cramps, in the form of cramps. Pain in the lower back usually occurs, similar to menstruation pain but stronger.

How to differentiate the pains of early pregnancy from a miscarriage symptom? In the first weeks of gestation, it is normal to feel mild cramps or a certain sensation of abdominal tightness. On the other hand, when a spontaneous abortion occurs, the cramps are more intense and constant .

Ultrasound with absence of embryonic activity

Ultrasound is one of the diagnostic tools used in the event of a threatened abortion. When there is a loss of blood or there is acute abdominal pain, the doctor performs an ultrasound to monitor embryonic activity , detect fetal heartbeat and check that the size of the fetus corresponds to the gestational age.

Some miscarriages are detected at routine prenatal check-ups, without any symptoms having yet manifested . The ultrasound shows that fetal development has stopped and that there is no heartbeat. In the case of delayed or missed abortion, fetal death occurs weeks before symptoms such as bleeding or colic appear.

Along with the ultrasound, the doctor may perform a vaginal examination to determine if the cervix is dilated , a sign that the pregnancy may be aborted.

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Disappearance of pregnancy symptoms

One of the signs that may indicate the termination of pregnancy is the non-persistence of pregnancy symptoms .

In the event of threatened miscarriage , a blood test is performed to determine quantitative beta HCG levels.

As the level of human chorionic gonadotropin in the blood decreases, the symptoms produced by it, such as nausea, breast tenderness, excessive tiredness, among others, tend to disappear . Even if the pregnancy test is repeated, it could be negative.

The decrease in the size of the gut , as the development of the uterus stops, can also be a symptom of a possible spontaneous abortion.

In case of suffering any of these symptoms, as well as high fever (more than 38º), tachycardia or loss of consciousness, it is necessary to see a doctor immediately . He will evaluate the state of the pregnancy and determine the steps to follow in each case.

These are the red flags that could indicate that the termination of pregnancy has occurred or is occurring. Natural or spontaneous abortion is more frequent than we think, but it is no less painful for the couple.

Photo | Анастасия Гепп from Pixabay
In Babies and more | Natural abortions: can they be prevented? The seven most common myths about miscarriage that are not true, Recurrent abortions: what they are and why they occur, causes and treatments

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