Causes of threatened miscarriage in early pregnancy. We draw conclusions: possible causes of the threat of miscarriage. Symptoms and signs

A miscarriage in medicine is a spontaneous (not artificial) termination of pregnancy by the body itself, which for some reason can no longer bear a fetus. A very tragic ending, because of which families collapse, young parents become depressed and are very worried. Very rarely does this happen unexpectedly. Most often, it is possible to make a timely diagnosis, which sounds like a threat of miscarriage, and begin treatment as quickly as possible, which saves mother and baby.

Everyone wants to avoid this condition, which is why it is so important to know as much information as possible about it in order to prevent, recognize, and treat it in time.

There are the most different reasons Threats of miscarriage: they are usually dictated by the characteristics of the fetus, the state of the mother’s health, or some external factors. While carrying a baby, a woman faces many dangers, each of which at a certain moment can provoke termination of pregnancy. The most common are:

• lack of progesterone necessary to continue pregnancy;
• excess androgens (these are male hormones that actively suppress female ones);
• rejection of the fetus by the mother’s body due to incompatibility with a man at the genetic level;
• mismatch of Rh factors: negative - in the mother, positive - in the father;
• abnormal blood clotting (increased);
• pathological structure of the uterus: defects in its development, non-standard shape(saddle-shaped, two-horned) prevent fastening ovum;
• infectious diseases: rubella, chlamydia, syphilis, pyelonephritis, pneumonia and even;
• gynecological diseases: uterine fibroids, endometritis, inflammation, sutures in the uterus;
• previous abortions and miscarriages with curettage, as it damages the endometrium;
• endocrine diseases: thyroid problems;
• taking some medicines contraindicated for bearing a child;
• herbal medicine: for example, the active use of parsley, nettle, St. John's wort, tansy in any form - and the threat of miscarriage early stages provided for you;
• common cause of threatened miscarriage later- pathology of the cervix or placenta;
• emotional state of a pregnant woman: constant stress, nervousness, resentment, anxiety, discontent;
• work until the deadline;
• dubious lifestyle: drugs, strong coffee and others harmful products, smoking, alcohol;
• falling, jumping, blows to the stomach, heavy physical activity;
• aging of the egg: according to statistics, in women over 35 years of age, the threat of miscarriage is diagnosed 2 times more often.

There may be only one reason, or a combination of them may work. In this matter, everything happens very individually. It is very important to identify a dangerous factor in time and exclude it from the life of the expectant mother, if possible. In order not to be late with treatment, you need to know the main signs of a threatened miscarriage, which will become alarm signal, notifying about an urgent visit to the gynecologist.

Stubborn statistics. According to data, 20% of all pregnancies end in miscarriage.

Symptoms

The complexity of the clinical picture of this diagnosis is that the symptoms of threatened miscarriage are very few - this is the first thing. And secondly, they may indicate completely different processes and pathologies of pregnancy. But in any case, at the first sign you need to immediately go to the doctor or call an ambulance. May be of concern:

• vaginal discharge when there is a threat of miscarriage, which can be different: spotting, abundant, long-lasting, transient, bright in color and vice versa - pale; they can stop and then resume again;
• pain, pulling sensations, feeling of heaviness in the lower abdomen and lumbar region;
• If there is a threat of miscarriage, the temperature can rise to 38-39°C, but this symptom is not required for this pathology.

These are characteristic features threats of miscarriage in the early stages: the triad of bleeding - pain - temperature should always worry young parents during pregnancy, both in combination and separately from each other. This serious reason for going to the hospital.

Note! In the later stages, there may be a threat of miscarriage even in the absence of bloody discharge, but it will be accompanied by liquid, watery discharge light color. This evidence is due to a violation of the integrity of about membranes.

Deadlines

Most exciting question for all young mothers: until what time is there a threat of miscarriage in gynecology. The answer is quite accurate: up to 22 weeks. Modern medicine is capable of resolving premature baby after given period, if it weighs more than 675 grams. So at 22 weeks it will already be called premature birth.

Depending on the period of pregnancy, there are several types of this diagnosis:

1. The threat of miscarriage at the 12th week of pregnancy and before this period is called early.
2. From 12 to 22 weeks - late.

Miscarriages often occur in the first 2 weeks after conception, when a woman is unaware of her pregnancy and perceives bleeding as unscheduled menstruation. This is fraught serious complications, if the remains of the fetus do not come out completely and begin to decompose in the uterus.

So the first trimester of pregnancy is very dangerous in this regard. The main thing is to wait until 22 weeks, when the threat of miscarriage passes and you can give birth to a baby, who can be saved by the innovative technologies of modern medicine. In particular, she successfully resolves all issues accurate diagnosis pathology.

From a psychological point of view. It is believed that early threat A miscarriage is not as painful for young parents as a late one, when they have already gotten used to the baby and have already begun preparing for his birth.

Diagnostics

Now let's find out how to determine the threat of early miscarriage using modern diagnostic methods in the hospital. This occurs either after a woman contacts a doctor with complaints about symptoms characteristic of this diagnosis, or after scheduled inspection at the gynecologist.

1. A gynecological examination allows you to determine the condition of the cervix.
2. An ultrasound is also performed if there is a threat of miscarriage, which shows what is happening to the fetus, placenta, as well as features of the uterine structure.
3. A blood test is taken to determine the level of progesterone, and sometimes thyroid hormones.
4. Analysis for viruses (rubella, toxoplasma, cytomegalovirus).
5. Antibody test for human chorionic gonadotropin(hCG).
6. Urine analysis for the presence of ketosteroids (so-called KS-17).
7. Blood test and smear to detect bacterial sexually transmitted infections (chlamydia, gonorrhea, mycoplasmosis, ureaplasmosis).
8. Coagulogram - determination of the state of blood clotting. It is prescribed if previous pregnancies also ended in the same tragic way (miscarriage).

All these diagnostic measures are aimed at determining the real reason threat of miscarriage, according to which treatment is selected.

Medical educational program. If there is a threat of miscarriage, an analysis is performed to detect 17-ketosteroids (they can be designated as 17-KS) - a metabolic product male hormones, which is excreted in the urine.

Treatment

Sedatives and antispasmodics for threatened miscarriage

Treatment for threatened miscarriage depends on the cause of the condition and the severity of the pregnant woman’s situation. The woman is left in the hospital or sent to be treated at home. The question of how long they stay in the hospital with a threat of miscarriage is decided in each case by the doctor individually - until the fetus is fully consolidated. This could be 5 days, or it could be the entire first trimester.

Medicines

Usually drug treatment in the early stages, if there is a threat of miscarriage, it comes down to prescribing the following drugs and procedures.

1. Complete peace.
2. Most often - bed rest.
3. Calming medications help normalize a woman’s emotional state when there is a threat of miscarriage, since she should not be nervous or worried at these moments. Usually these are tinctures of motherwort and valerian.
4. Psychotherapy sessions are prescribed for the same purpose.
5. Medicines for uterine bleeding: Dicinone (hemostatic injections), Etamzilat, Tranexam (tablets).
6. For hyperandrogenism, corticosteroids are prescribed: Prednisolone, Dexamethasone, Metipred.
7. Usually, when there is a threat of miscarriage, antispasmodics are prescribed to reduce the tone of the uterus: No-shpa, Drotaverine, Magnesia (magnesium sulfate), Papaverine (suppositories).
8. Treatment of identified infections.
9. Vitamins to strengthen the body: (vitamin E), ascorbic acid(vitamin C).
10. Hormonal drugs Duphaston in case of threat of miscarriage or Utrozhestan containing synthetic analogue progesterone. They are prescribed in the first trimester.
11. In case of cervical insufficiency, conservative or surgical therapy is prescribed. Mechanical narrowing is carried out internal pharynx at the cervix (which is defective) or suturing its external pharynx.

Sometimes the main therapy, with the permission of the doctor, can be supported by folk remedies. But only if the bleeding situation is not so serious and does not require hospitalization.

ethnoscience

If there is a threat of miscarriage folk remedies should be used with caution and only after consultation. With this diagnosis, the following recipes are recommended.

• Dandelion

Pour 5 grams of fresh dandelion leaves or root into a glass of water and boil for 5 minutes. Drink 50 ml three times a day.

• Viburnum bark

Pour crushed viburnum bark (1 tsp) into a glass of water and boil for 5 minutes. Drink 15 ml three times a day.

• Viburnum flowers

Pour 30 grams of viburnum flowers into 1.5 liters of boiling water. Infuse (preferably in a thermos) for at least 2 hours. Drink 50 ml three times a day.

• St. John's wort + calendula

Mix in equal quantities fresh flowers St. John's wort and calendula (1 teaspoon each), pour a glass of boiling water. Leave for half an hour (preferably in a thermos). Drink 2 glasses a day, adding honey.

Here are the drugs prescribed for a threatened miscarriage: early stages. In the later stages of this diagnosis, it is suggested to place a ring on the cervix, preventing its premature opening. This is a fairly simple operation with virtually no contraindications or undesirable consequences.

You need to know this! Many herbs are contraindicated during pregnancy. Therefore, if you are tempted to use herbs to treat the threat of miscarriage, study as much information as possible about this plant. Especially the list of contraindications.

When a pregnancy is suspected of being terminated, women begin to panic, not knowing what to do if there is a threat of miscarriage and how to behave in order to save the child. Some useful tips They will help you come to your senses and not make things worse.

First aid

1. Call an ambulance.
2. Move as little as possible.
3. Do not panic.
4. Before the doctor arrives, lie down and try to relax.
5. If there is a threat of miscarriage, sex is contraindicated, as is anal sex, oral sex, orgasm, self-satisfaction. This leads to contractions of the uterus, causing miscarriage.
6. You cannot perform any physical activity, jumping, lifting weights.
7. Do not drink alcohol or smoke.
8. Try not to be nervous.
9. Do not use the sauna.
10. Many people are interested in whether it is possible to take a bath if there is a threat of miscarriage: of course, following the rules of personal hygiene is mandatory, but beware of hot temperatures. The water should be warm, and the duration of use water procedures should not exceed 10 minutes.
11. Do not make sudden movements.
12. Coffee and chocolate are contraindicated.
13. Do not self-medicate.

On home treatment

Compliance with these simple rules will allow you to save the life of an unborn baby who has already encountered problems in the womb serious difficulties on his way. Sometimes they ask whether the threat of miscarriage can go away on its own: yes, this happens quite often if you follow the above recommendations.

Information for men. If your wife has been diagnosed with a threatened miscarriage, you must do everything to prevent a tragic ending. This is within your power in most cases: protect your baby’s mother from worries of any kind and physical activity.

Forecasts

If a threat of miscarriage was diagnosed early in pregnancy, this will not affect subsequent pregnancies in the future. According to doctors, there is only a 1% chance of the situation repeating itself. Although this risk increases with each premature interruption.

It is much more dangerous if there is a threat of miscarriage at 20 weeks: you can lose a child whose birth is not yet possible due to short term. The consequences may be:

• infection of the uterus;
• abscess in the pelvic cavity;
• septic shock;
• death (extremely rare).
• depression, feeling of constant guilt due to the loss of a child.

These are the complications that can result in the threat of spontaneous miscarriage for a woman. Each of them entails a long course of treatment. Therefore, it is so important to take preventive measures in time, which you need to think about even when planning a pregnancy.

Prevention

Before pregnancy take preventive measures for this diagnosis is much simpler. If the child is desired and planned in advance, it would be useful for parents to learn how to prevent the threat of miscarriage, first - before the moment of conception, and then during pregnancy.

1. Before conception, both parents must undergo a comprehensive medical examination and tests for genetic compatibility.
2. Treat any infections as soon as they appear.
3. Avoid contact with infected people. Visit places with large crowds of people less often.
4. Don't smoke, don't drink alcohol, don't use drugs.
5. Eat properly.
6. Do not be nervous. If you can't avoid stressful situations, ask your doctor to prescribe sedatives that are not contraindicated during pregnancy (this could be valerian or motherwort).
7. Avoid excessive physical activity.
8. Avoid falls and blows to the stomach.

These preventive tips will tell young parents how to prevent the threat of miscarriage in the early stages even before conception, at the stage of pregnancy planning. They should not be neglected, since the life and health of the mother and child depend on them.

According to statistics, about one quarter of pregnancies end in miscarriage, often long before the woman herself finds out about the pregnancy. What are the causes and symptoms of miscarriage? And what to do in this situation? These and other questions concern women who are preparing to become a mother or are just planning.

A miscarriage is a complication of pregnancy, characterized by spontaneous (spontaneous) rejection of the fetus during a period when its viability outside the uterus is impossible. Miscarriage and premature birth are different concepts. If after giving birth, even prematurely, a child can be “exited”, then after a miscarriage the fetus simply dies. To date modern medicine makes it possible to maintain vitality premature fetus born at 25 weeks of gestation. In this case, the fetus subsequently grows and develops normally, like children born at term.

Bleeding of varying intensity and duration during pregnancy, as well as painful sensations are a signal for immediate appeal behind medical care, as they may be the beginning of a miscarriage.

There are miscarriages caused by natural causes(spontaneous) and artificial (termination of pregnancy or abortion), which can be provoked by medical indications. Typically, most spontaneous (spontaneous) miscarriages occur during the first trimester of pregnancy. But spontaneous termination of pregnancy (miscarriage) after twenty weeks intrauterine development accounts for one percent of all pregnancies. Numerous studies have found that miscarriage is twice as likely to occur in women over the age of 35 than in younger women. However great importance at the same time has the health of the woman herself.

It is believed that the absence of toxicosis in a pregnant woman during the first trimester of pregnancy (due to hormonal imbalance in the body) indicates that this woman is prone to miscarriages. Of course, this is not the rule, since many women who do not experience morning attacks of nausea and lightheadedness subsequently carry their pregnancies to completion and give birth to healthy children.

What should women do if they are at risk of miscarriage during pregnancy? The most important thing is not to panic! After all, the outcome of the pregnancy (miscarriage or birth of a child) will depend on the correctness of your behavior during pregnancy.

Causes spontaneous miscarriages.
There can be many reasons for spontaneous miscarriages. An important role is played by the woman’s health, history of previous pregnancies, the presence and number of abortions, etc. More than half of miscarriages occur in women due to improper genetic development fetus, which may be due to hereditary or random factors. Blastocystosis is a common cause of miscarriages (60% of cases); it contributes to the development of fetal abnormalities that make it impossible for it to mature. IN in this case The woman’s body destroys the defective and non-viable fetus. 10-15% of miscarriages occur by chance, in the absence of visible predispositions in the woman. Blastocystosis occurs through the fusion of “low-quality” germ cells of the mother and father. As a rule, in this case, a miscarriage occurs in the sixth or seventh week of pregnancy. It is impossible to prevent this, and it is not necessary, since the child as a result of blastocystosis will be abnormal. The possibility of a repeat miscarriage in this case is very low.

The causes of spontaneous miscarriages include many other factors: abnormal development uterus, tumors, cervical injuries, fibroids (but not always), erosion (often leading to ectopic pregnancy), adhesions after inflammatory lesions, serological conflict, acute infectious diseases that the pregnant woman suffered in the first trimester, general diseases, chronic diseases(syphilis or toxoplasmosis), unfavorable environmental conditions, radiation, difficult conditions labor, physical, emotional and psychological stress, alcohol, drugs and medication, inflammatory processes in systems and organs, pyelonephritis, tonsillitis, pneumonia, appendicitis, diabetes.

One of the common causes of miscarriages is artificial termination of pregnancy (abortion), especially the first one. In many cases, miscarriage develops, which is diagnosed after three or more miscarriages in a row. A lack of the hormone progesterone in a woman’s body can also cause a miscarriage.

Abnormalities in the development of the placenta can also contribute to the threat of miscarriage. Women facing a similar situation are under strict medical supervision for a year. IN this period It is contraindicated for women to become pregnant.

In addition, miscarriage can be caused by ruptured membranes and intrauterine infections.

A woman's age can also cause the risk of miscarriage. Late pregnancy Its onset is considered after the age of 38 years.

Lack of nutrition and poor nutrition, as well as elevated blood sugar levels can also trigger spontaneous abortion.

The threat of miscarriage during pregnancy occurs in women who have undergone infertility treatment, as well as in cases of multiple pregnancies.

Diagnostic procedures in rare cases can cause spontaneous interruption pregnancy (fetal biopsy - stretching of the outer layer of the membranes of the embryo is performed - puncture of the umbilical vein).

It is worth noting that regardless of the reasons that caused the miscarriage, each spontaneous termination of pregnancy increases the risk of recurrence. However, if you listen to and follow all the recommendations of specialists, you can prevent a miscarriage.

Symptoms of miscarriage.
The symptoms of miscarriage vary, but the most dangerous are considered various kinds vaginal bleeding: in the first trimester of pregnancy (until the end of the 16th week). Symptoms of miscarriage can also be observed during next menstruation at 4, 8 and 12 weeks of pregnancy.

Cramping pain in the lower abdomen or lower back, spotting, and vaginal bleeding are the main symptoms of a miscarriage; in this case, you should urgently call a doctor.

Bleeding may be mild and minor character, be short-lived. The color of the blood can vary from red to brown, sometimes mixed with mucus. Bleeding in some cases may resemble normal menstrual cycle. It also happens that the bleeding is minor and stops spontaneously after a short time. If treatment is started on time, the pregnancy can be maintained. If bleeding intensifies and is accompanied by dull ache in the lower abdomen, this indicates the beginning of a miscarriage. A more intense development of these symptoms and rejection of tissue particles indicates that a miscarriage has already occurred.

As a rule, the embryo dies several days or weeks before its natural removal from the uterine cavity. Since its parts are very small, among bleeding they may not be noticed. Miscarriage is comparable to inflated balloon gray-white(if the placenta is intact). If the placenta is ruptured, pearly white particles may be seen in the blood discharge.

A miscarriage can be incomplete, complete or miscarriage.
Incomplete miscarriage - when the miscarriage is carried out and tissue sac(possibly with an embryo) enter the vagina. At incomplete miscarriage some tissue is excluded, and some blastocysts and small fragments of chorionic villus sampling remain in the uterus. The remaining parts cause bleeding. Therefore, the woman needs urgent surgical intervention(cleaning), otherwise intrauterine bleeding or infection may occur.

A complete miscarriage is considered when all parts of the fetus and placenta have been removed from the uterus. As a rule, a complete miscarriage occurs in the seventh week. In this case, the woman does not need cleaning.

A miscarriage is a so-called frozen pregnancy, in which the embryo dies and the pregnancy continues. Stillbirth can remain in the uterus for several weeks, even months. In this case, the uterus does not grow, but its cervix is ​​tightly closed. Ultrasound is the best way determining whether the fetus is alive or not. If the pregnancy is considered frozen, the fetus is removed from the uterus.

Partial separation of the placenta or membranes from the uterine wall can also cause bleeding. Pregnant women who experience spotting should always keep blood samples on a piece of tissue so that a monitoring doctor can examine them.

Treatment and prevention of miscarriages.
Taking into account the results of the examination of the pregnant woman, the doctor prescribes treatment. With minor pain, absence of bleeding and previous miscarriages, treatment can be carried out at home. During this period, it is recommended to abstain from sexual activity. There are cases when a miscarriage can be effectively prevented if treatment is prescribed taking into account the causes and nature of the complications. If there is a threat of miscarriage, a woman is exposed to medical examination and takes prescribed medications: most often those that have a diastolic effect, vitamins, painkillers, sedatives, hormonal drugs (including those that block the production of prostaglandins). In this case, the pregnant woman is advised to take bed rest.

As mentioned earlier, any spotting during pregnancy should be a reason to consult a doctor. As a rule, the doctor performs an ultrasound, and if the embryo is alive, the pregnant woman is sent to the pregnancy pathology department to maintain the pregnancy. 90% of such cases end in birth healthy child. Since there is still a risk of preterm birth, the pregnancy should be carefully monitored.

If a pregnant woman is diagnosed with a cervical malformation in the second trimester, she is given circular seams on the cervix. During pregnancy, the cervix must be closed to prevent the egg from falling out of the uterus. The effectiveness of this treatment is 80% of cases.

To prevent miscarriage due to serological conflict during pregnancy, in rare cases, an exchange transfusion is performed, which helps remove damaged cells, antibodies and excess bilirubin. At this process 75% of the child’s blood changes, but the child will continue to produce blood cells with its own antigens. In addition, patients are prescribed maintenance therapy, including intravenous administration albumin solution, which reduces the risk of free bilirubin entering the brain.

To prevent incompatibility, patients are administered immunoglobulin Rh D 72 hours after childbirth, miscarriages and abortions. Its action is aimed at eliminating Rh-positive fetal blood cells that have entered the mother's bloodstream. This procedure is repeated after each birth and miscarriage.

In the case when a serological conflict occurs in the second trimester of pregnancy, this indicates fetal death and subsequent miscarriage.

How to behave after a miscarriage.
It is important to abstain from sexual intercourse for two weeks after a miscarriage. In addition, it is not recommended to use tampons during this period. It is better if the first sexual intercourse occurs after the first menstruation after a miscarriage, which usually occurs 4-6 weeks after spontaneous abortion.

Experts recommend using contraceptive methods for 3-4 months after a miscarriage, since rapid attack pregnancy after miscarriage has risks associated with psychological state women after pregnancy loss that does not contribute to normal flow and the development of a new pregnancy.

A miscarriage does not mean that next pregnancy will end the same way. The chance of having a baby after three miscarriages in a row is 70%, four – 50%. No one can guarantee that the next pregnancy will pass without complications, however, a miscarriage does not mean that you do not have a chance for happy motherhood.

At the first signs of miscarriage, you should seek medical help. After all, the sooner treatment is carried out, the greater the chance that the fetus will be saved. In addition, you should not self-medicate at home or take medications without a doctor’s prescription. None ethnoscience is not able to prevent miscarriage, and various infusions and decoctions recommended by “compassionate neighbors” can only aggravate the situation.

Prevention will help prevent the threat of miscarriage in the early stages

Treatment of threatened miscarriage is prescribed only by a gynecologist. Moreover, if the patient’s condition allows, she can undergo the course on an outpatient basis. But if there is a pronounced threat to the pregnant woman, hospitalization is necessary. The drugs prescribed for threatened miscarriage depend on the cause of this phenomenon:

• At hormonal imbalance The patient needs a course of hormonal medications.
• For immunological factors, a course of medications is prescribed, the action of which is aimed at suppressing the production of antibodies.
• When the uterus is toned, medications are prescribed to relieve muscle spasm.

Often medications are administered intravenously. In this case, the names of the drugs and their dosage are chosen by the attending physician.

How to prevent miscarriage?

To avoid problems with pregnancy, a woman needs to regularly visit a gynecologist and strictly follow all his recommendations. Timely testing will help to recognize problems and pathologies in the early stages, because the earlier the diagnosis is made, the easier the treatment will be. In addition, the expectant mother should adhere to the following recommendations:

• Lead healthy image life. Bad habits can affect not only the course of pregnancy, but also the health of the unborn baby.
• Avoid stress and overwork, because they have a bad effect on the immune system.
• Do special exercises for expectant mothers. You can find out which exercises are suitable for your case from your gynecologist.
• Do not take medications without a doctor's prescription. During pregnancy, you should avoid taking any drugs, because they active substances along with the blood they reach the baby.
• Keep track of your daily routine. It is extremely important for the expectant mother to adhere to a sleep and rest schedule.

Nagging pain in the lower abdomen during pregnancy, spotting, uterine tone and lower back pain. Yes, these are symptoms of a threatened miscarriage in the early stages. Calmly! We can help you, the main thing is to consult a doctor in time. And we will help you with advice on how to avoid such a situation.

Let's first figure out what the phrase “threat of miscarriage” means. This pathological condition in a woman’s body when it occurs real risk to terminate pregnancy, fetal death, or the birth of a premature baby.

Depending on the stage of pregnancy, there are:

threatened abortion (before 12 weeks of pregnancy);

threatened miscarriage (up to 22 weeks);

threatening premature birth (from 22 to 36 weeks).

The threat is especially dangerous in the first two trimesters, when the risk of losing a child is highest due to the fact that the baby is not viable. But even in the third trimester of pregnancy, threatening premature birth requires urgent treatment, because nursing a prematurely born baby will require a lot of effort.

Reasons for threatened miscarriage

There are so many reasons for the threat of miscarriage that it is easier to divide them into separate groups:

general diseases (heart defects, vascular diseases, spinal problems, kidney disease, anemia);

infectious (any type of microbe – bacteria, viruses, fungi, protozoa);

genetic (fetal malformations, congenital anomalies);

anatomical (bicornuate uterus, duplication of the uterus, septum in the uterus) changes inner surface uterus after traumatic operations and abortions (synechia, defect of endometrial receptors);

endocrine-metabolic (general and gynecological hormonal disorders, metabolic disorders, water-electrolyte imbalance with changes in the concentration of microelements);

immunological (formation of various antibodies that contribute to fetal rejection);

weakness of the circular muscle in the lower part of the uterus, when, at 14-16 weeks, isthmic-cervical insufficiency (ICI) occurs and premature opening of the fetal sac occurs;

injury (fall, blow) and physical activity;

severe stressful situation;

use of toxic drugs;

bad habits, especially smoking, coffee abuse, fasting and frequent constipation.

It is possible that the reason for the threat of interruption is completely unclear. Neither the woman nor the doctor can understand why symptoms of a pregnancy-threatening condition occur.

Symptoms of threatened miscarriage

1. Pain in the lower abdomen

Do not think that if there is a threat of miscarriage, the pain will only be in the lower abdomen. It happens that discomfort occur in the lower back and sides. They can be different in nature: pulling, cramping, aching, cutting.

2. Vaginal bleeding

As a rule, if heavy bleeding occurs, it is almost impossible to maintain the pregnancy. And vice versa: if the blood is released very sparingly, then there is a very high chance of continuing pregnancy. In any case, even with minimal manifestations in the form of dark blood staining the pad, you should quickly consult a doctor.

3. Hard belly in the uterine area

This is very unpleasant symptom, because it points to increased tone muscles of the body of the uterus. It can cause contractions that will lead to premature birth in the third trimester or to a miscarriage - with a short period of pregnancy.

During a gynecological examination, the doctor will notice these manifestations (increased uterine tone, presence of blood). In addition, the doctor will evaluate the cervix (length, density, opening of the external os), which is blocking the baby’s exit from the womb.

With the help of ultrasound, the gynecologist will be able to see not only the threat, but also its possible cause (anomaly of fetal development, placental previa and abruption, signs intrauterine infection, blood flow disturbance). With an ultrasound examination, you can always assess the baby’s condition and, if necessary, take everything possible measures to preserve pregnancy and save the life of the fetus.

Consequences of the threat of miscarriage for a child

If you had a threat of miscarriage from the first trimester, and for this reason you often had to stay in the hospital, then there is a risk of fetal growth restriction (IUGR). In addition, if the culprit of this condition is an infection, then the risk of intrauterine infection of the fetus and amniotic fluid, which will cause sepsis in the baby and premature rupture of the membranes.

With vascular disorders and trauma, placental abruption may occur. Insufficient oxygen supply to the brain tissues often causes organic damage or severe functional disorders (perinatal encephalopathy). In any case, the threat of miscarriage is a serious and dangerous problem during pregnancy.

For pain in the lower abdomen, and also, if there is hard belly and discomfort in the uterus and lower back, you should consult a doctor to start maintaining your pregnancy as quickly as possible. If even minimal bleeding appears, you should immediately go to the hospital. Whatever things are planned, the woman needs to postpone them until later and do everything possible to maintain the pregnancy. Optimal choice- this means going to the hospital in an ambulance.

Treatment of threatened miscarriage

In the hospital, to maintain pregnancy, you must follow the doctor’s recommendations. The basis of therapy will be the following measures:

- bed rest (sometimes this is the most best treatment when a woman stops going to work and doing household chores);

- reception hormonal pills or vaginal suppositories (duphaston or utrozhestan);

- intramuscular or rectal administration of papaverine;

- taking magnesium drugs (magne-B6, magvit, magnesia) or tocolytic drugs that relieve increased uterine tone (ginipral);

— with ICN, the doctor places a suture on the cervix, which ensures the preservation of pregnancy;

- drugs are used to improve blood flow between mother and fetus.

Prevention of the threat

In the case when timely therapy gave positive result, and managed to maintain the pregnancy, then after discharge from the hospital you should immediately consult a doctor to continue treatment. Sometimes you have to follow the doctor’s recommendations during the months remaining before giving birth. Here's what you need to do to avoid another risk of miscarriage:

— restriction of sexual activity and severe physical activity;

- usage prenatal bandage;

— compulsory treatment infections, general and endocrine diseases;

- taking magnesium and calcium supplements;

- use of utrozhestan up to 36 weeks of pregnancy;

- preventive hospitalizations at a time determined by the doctor.

During pregnancy there are different situations that threaten the baby's life. And a woman should first of all think not about everyday affairs or problems at work, but about the life and health of the baby, about his correct growth and development. With all dangerous symptoms, you should, without hesitation and postponing the problem until later, quickly seek medical help in order to do everything possible to maintain the desired pregnancy.

The threat of miscarriage is diagnosed by a specialist with a confirmed live pregnancy. A woman cannot always recognize the symptoms of this process on her own. In the early stages, spontaneous abortion occurs like menstruation and can be completely painless.

The presence of small spotting in the first weeks of pregnancy is considered normal and occurs in every second woman. It is worth paying attention to this and notifying the gynecologist leading the pregnancy. The doctor must conduct ultrasonography and, if necessary, prescribe treatment.

Such discharge can bother a woman throughout her pregnancy. If the doctor does not find any abnormalities, the pregnant woman is recommended to rest completely and avoid any physical activity.

There are 2 diagnoses when treatment is really necessary - “abortion in progress” and “abortion in progress”. They are characterized by heavy bleeding, pain in the back and lower abdomen. In these cases, the woman needs urgent hospitalization and qualified assistance from specialists. In obstetrics there is such a thing as “risk”. Each pregnancy is assigned a certain level of risk.

It is calculated based on the following data:

• age of the pregnant woman;
• living conditions;
• bad habits;
• genetic factors;
• Family status;
• diseases internal organs;
• menstrual function;
• the presence of previous pregnancies, childbirth, their course;
• the presence of miscarriages, stillbirths;
• diseases of the blood and endocrine system;
• diseases of the urinary and respiratory organs;
• infectious diseases;
• various neoplasms;
• complications of pregnancy: multiple births, toxicosis, gestosis;
• incorrect position child;
• placenta previa;
• disturbances of amniotic fluid;
• large fruit;
• Rhesus conflict;
• fetal condition: malnutrition, hypoxia, congenital malformation.

During pregnancy, such an analysis is carried out 3 times: upon registration, at 20-24 weeks and at 30-34 weeks. Depending on the data obtained, the woman is given recommendations or treatment is prescribed. High degree risk is not a death sentence at all.

With careful and proper observation and care, pregnancy in most cases can be maintained regardless of these indicators.

Possible causes of the threat

The threat of early miscarriage, the symptoms of which are difficult for a woman to recognize on her own, has a number of reasons:

1. Statistics say that about 70% of miscarriages occur due to genetic defects in the embryo. This is not a consequence hereditary diseases, and mutations of the germ cells of the parents. A miscarriage like this cannot be stopped. You can only reduce the risk of such an outcome. Namely, exclude the use of alcohol, strong drugs and narcotic drugs. This applies to both women and men.
2. High or low level progesterone hormone, thyroid gland and androgens. If these factors are identified in time and treatment is started, then the pregnancy proceeds normally.
3. Abortion disrupt the functioning of internal organs and often cause miscarriage.
4. Rhesus conflict. It happens if the mother is negative and the fetus positive Rh factor. This is detected early in pregnancy and can be successfully treated with medication.
5. Medications(hormonal, antibiotics containing narcotic substances) and herbs (parsley, nettle, St. John's wort, tansy).
6. Physical activity, injuries, sexual intercourse, falls, emotional stress.
7. Drinking alcohol, smoking, caffeine in large quantities.
8. Irregular structure of the uterus. This is genital infantilism, the presence of septum, a bicornuate uterus.
9. Scars after surgery caesarean section.
10. Infectious diseases:

• hepatitis;
• inflammation of the appendix;
• influenza diseases;
• pyelonephritis;
• herpes;
• pneumonia;
• gonorrhea;
• trichomoniasis;
• toxoplasmosis;
• chlamydia;
• cytomegalovirus.

The risk of early miscarriage increases due to these diseases. If you find suspicious symptoms, you should consult your doctor. To completely eliminate this factor, a woman is recommended to undergo a thorough examination at the stage of pregnancy planning.

In the 2nd and 3rd trimesters, the following factors can be added to the above factors:

• Abruption or placenta previa.
• Pregnancy gestosis.
• Excess amniotic fluid.
• Isthmic-cervical insufficiency.
• Low blood clotting.

Symptoms and signs of possible miscarriage

The threat of early miscarriage, the symptoms of which are described below, can be identified by a woman on her own. It is important to note any change in well-being and, at the slightest suspicion, seek help.

Dangerous symptoms:

• Bloody discharge.
• Drawing or cramping pain in the lower abdomen.
• High uterine tone.
• Watery discharge in the 3rd trimester.

The threat of self-abortion can also be determined by ultrasound, even in the absence of complaints from the pregnant woman: disturbance of the baby’s heartbeat, uterine tone, uterine size larger or smaller than normal.

Pain in the early stages

During pregnancy, almost all women experience pain in the abdominal area. May bother your back and legs. Together with the fetus, the uterus also grows, which puts pressure on adjacent organs and puts additional stress on the entire body. Therefore, some discomfort, fatigue, and sleepiness are considered normal.

Pain often begins to bother a woman from the first days of pregnancy. If they are quite intense and do not go away after rest, the woman should suspect an ectopic pregnancy and immediately contact an ambulance.

It happens that the egg begins to grow in fallopian tube and does not descend as expected into the uterine cavity. This is called ectopic pregnancy. In this case, surgical intervention is vital.

Pain can also cause increased tone of the uterine walls. This is a rather dangerous symptom. A doctor can determine the tone during an examination, as well as an ultrasound. As a rule, tension is relieved with medications and bed rest.

Discharge from the genital tract

The threat of early miscarriage, the symptoms of which may resemble inflammation of the appendages, is almost always recognized by the presence of discharge. They can be different color: scarlet to dark burgundy. The discharge can be copious or light, spotting.

Rhesus conflict

Rh conflict occurs when a pregnant woman has a negative Rh factor, but the fetus has a positive Rh factor. Fetal red blood cells penetrate into the blood of a pregnant woman and are perceived by her immune system as something foreign. As a result, antibodies are synthesized that destroy the child’s red blood cells.

The liver and spleen produce more red blood cells and become larger as a result. They cannot cope with such a load, it comes oxygen starvation. In addition, bilirubin is produced in the fetal blood, which can damage its brain. All this can lead to irreversible consequences.

When registering, all pregnant women are tested for the Rh factor. If it is negative, then the same test is taken from the child’s father. If the result is positive, the mother is tested for antibodies at least once a month. And starting from 32 weeks - 2 times a month.

If antibodies are detected, treatment is carried out in a hospital under the supervision of doctors. In the first 3 days after giving birth, a woman is given a drug called “ anti-Rhesus immunoglobulin" Thanks to it, you can prevent Rh conflict in your next pregnancy.

Isthmic-cervical insufficiency

The threat of miscarriage in the early stages (symptoms in this case may be absent) can arise as a result of ICI. It develops due to weakening of the muscle ring, which is located in the area of ​​the internal pharynx. As a result, the amniotic membranes begin to descend into the resulting lumen.

This condition can lead to rupture amniotic sac, premature birth and fetal death. In this situation, there is a danger of infection reaching the child directly.

The cause of ICN is a decrease in the tone of the muscles that form the uterine sphincter. This pathology does not manifest itself in any way. And it is impossible to diagnose it in advance. At mild form Strict bed rest is prescribed. In case of complications, a Meyer ring is placed in the vagina. It helps reduce fetal pressure on the cervix.

In some cases, they resort to suturing. This operation is performed under anesthesia. It is recommended that pregnant women with this diagnosis be sent to a hospital in advance, since childbirth most often occurs quickly and you may not have time to get to the maternity hospital on your own.

Treatment according to the Sunnah

Not in all countries women turn to a doctor with their problems. Even in the most difficult situations prefer to trust the teachings of their ancestors. This approach is called prophetic medicine or Sunnah healing. The books describe various procedures and products that can cure all diseases.

For example:

• black cumin;
• helba;
• bloodletting procedure.

There are no prohibitions in Islam traditional medicine. However, its level and inaccessibility for many make unconventional methods more and more attractive. As with any treatment, you should strictly follow original instructions described in the original sources. For any method there are specific indications.

Muslim women often and quite successfully use treatment according to the Sunnah for infertility and the threat of miscarriage. There are gynecologists who work according to these teachings and who can always be contacted completely free of charge.

Medications

Used in treatment different groups means:

1. One of the most popular drugs for the threat of miscarriage is Papaverine. It is available in tablets, suppositories and injections. the main task means to reduce muscle tone. In addition, it has a calming effect and reduces arterial pressure.
2. Magnesium or magnesium sulfate prescribed intravenously or intramuscularly. It eliminates cramps, significantly reduces the tone of the uterus, lowers blood pressure, has a diuretic effect and eliminates swelling, has a positive effect on nervous system, strengthens cell membranes.
3. Progesterone. Lack of this hormone is the main cause of abortion. It reduces the contractile function of the uterus and promotes the normal course of pregnancy. The drug is prescribed in the form of suppositories or tablets. Most popular titles - Utrozhestan and Duphaston.
4. During pregnancy, hCG is monitored. If its level is below normal, then hCG in required dose administered intravenously to the patient.

Amount of vitamins and high-quality composition must be prescribed by the attending physician. Especially important role plays vitamin E. It has an antioxidant effect, helps maintain pregnancy and proper development fetus

Folk remedies for home treatment

Any medicines are used only with the permission of an obstetrician-gynecologist or a therapist in a antenatal clinic.

This also applies to various folk recipes:

• Dandelion decoction. 5 g of raw material should be filled with 200 ml of water. The resulting mixture is boiled for 5 minutes. The broth is filtered and cooled. Take it ¼ cup 3 times a day. The same decoction can be prepared from dandelion root.
• A decoction of crushed viburnum bark. 1 tsp bark, pour 200 ml of boiling water and boil for 5 minutes. Use 1 tbsp. 3 times a day.
• You can also use viburnum flowers. 30 g of raw materials must be poured into 1.5 liters of boiling water. Leave for 2 hours. Drink ¼ glass 3 times a day.
• For small bloody discharge A decoction of calendula flowers may help. 200 gr. raw materials are poured into 1 liter of water. Boil the product until only half of the water remains. The broth is cooled and filtered. Drink it 100 g up to 5 times a day.

How is treatment carried out in a hospital?

The threat of early miscarriage, the symptoms of which are not always obvious, can be a reason for hospitalization. It can be of two types: planned and emergency.

Planned hospitalization is prescribed in the following cases:

• diabetes, kidney and heart diseases, arterial hypertension;
• premature termination of previous pregnancies;
• if conception occurred as a result of IVF or hormone therapy.

The hospital performs tests that cannot be performed on an outpatient basis. Prevent complications. The duration of hospitalization is discussed with the doctor. If necessary, a woman can spend up to 3 weeks in the hospital. Emergency hospitalization is carried out in the event of a threat to the life and health of the mother or child. Such situations can arise at any time.

Up to 12 weeks, women are hospitalized in the gynecological department, and after that - in the pregnancy pathology department. In any case, they are carried out necessary research(ultrasound, fetal CTG). Tests are taken. The woman is under observation until the dangerous condition is eliminated.

In addition to the above mentioned options, a pregnant woman may be offered day hospital. This is a special department, usually located in a clinic (antenatal clinic), where the patient stays for a couple of hours a day. Here they put IVs, give injections and other procedures. Which cannot be done at home.

Possible complications during pregnancy

Depending on the initial state of health and external factors A pregnant woman may experience various complications:

• Diseases and conditions associated with pregnancy. This could be toxicosis, gestosis, varicose veins, diabetes, anemia.
• Complications of pre-pregnancy diseases:
• thyrotoxicosis;
• cardiomyopathy;
• hypothyroidism;
• diabetes;
• gastrointestinal diseases.
• Threat of miscarriage.
• Ectopic pregnancy.
• Fetal pathologies:
• intrauterine infection;
• genetic abnormalities;
• fetal hypoxia;
• malnutrition.
• Presentation, incorrect position. Causes complications during childbirth.
• Rhesus conflict.
• Pathology of the placenta. Inflammatory processes, tumors, and cysts develop in the tissues of the placenta.
• Umbilical cord pathology:
• inflammatory processes;
• hematomas;
• cysts;
• nodes;
• lengthening or shortening of the umbilical cord.
• Polyhydramnios and oligohydramnios, rupture of the fetal sac, chorioamniotitis.
• Death of the fetus and its preservation in the uterine cavity, which leads to severe inflammation: sepsis, purulent endometritis, peritonitis.

How to prevent miscarriage and save your baby

To reduce the risk of early miscarriage, you need to plan your pregnancy carefully. Monitor yourself for all your symptoms possible diseases, hand over everything possible tests. To ensure that future parents do not miss anything, antenatal clinics have family planning rooms.

If the mother or father suffers from any diseases, they must be treated before pregnancy.

It is necessary to register with the antenatal clinic and conscientiously carry out all assignments and recommendations. A pregnant woman needs rest and positive emotions. We must not forget about a nutritious, varied diet and giving up bad habits.

Useful videos about the threat of miscarriage