Threatened Abortion

Prevalence of Threatened Abortion: 25% (Pretty High Huh?!)

Presentation of Threatened Abortion: Threatened abortion usually shows itself by hemorrhage before 20 week of pregnancy. On history, the patient denies any extraction of tissue. On physical exam: Cervix is closed, no fetal tissue passage is noted, no cervical or vaginal lesion is seen. Also fetal heart rate is usually normal and ultrasound shows normal product or pregnancy.

Management of Threatened Abortion: There is another posting with the topic of Management of First Trimester Bleeding, so read that first.
When the Patient comes to you first step is to make sure fetus is alive. Once that is fulfilled and the diagnosis of Threatened Abortion is made, management is reassurance and performance of Ultrasonography one week later.

Treatment of Threatened Abortion is Reassurance and outpatient follow up.

Differential Diagnosis of Threatened Abortion:
- Any other reasons of first trimester abortion can be considered as differential diagnosis of threatened abortion, including:
- Incomplete abortion: OS is open and there is no viable product of pregnancy
- Complete abortion: OS is closed, Ultrasonography shows empty uterus
- Inevitable abortion: Dilated Cervix, Sonogram shows rupture or collapsed gestational sac with absence of fetal cardiac motion, history of tissue extraction.
- Complete Abortion: OS is closed; Product of Pregnancy has come out completely.