Threatened Abortion

Vaginal bleeding

• 25% of all pregnancies may have vaginal bleeding of some sort
• 50% (at worst in some studies) may go on to have a miscarriage
• 11-14% may go on to have a miscarriage if a live IUP with FHT on bedside ultrasound
• 2/3 of miscarriages have chromosomal abnormalities - nothing patient caused nor can save
• Medicines or procedures available to save a pregnancy / prevent an miscarriage: none

Indications for RH screening and treatment (prevent Erythroblastosis fetalis)

• After a 1st trimester pregnancy Loss
• Threatened Abortion
• Second or third trimester antenatal bleeding
• Abdominal trauma
• Medical Interventions (chorionic villus sampling, amniocentesis, abortion, etc)

Management of incomplete miscarriage (<13 weeks) - No difference in outcomes (Cochrane Database, 2010)

• Expectant - “wait and see”
• Misoprostol
• Surgical - D&C

Pitfalls in bedside ultrasound - mistaking as normal IUP when its a:

• Pseudosac
• Cervical pregnancy

Ultrasound in First Trimester