THREATENED ABORTION

Clinical Features

As shown in Table .

Etiology

Approximately half of miscarriages are due to chromosomal abnormalities in the fetus.

Maternal factors can also play a role in a threatened abortion. Maternal infection can increase the chances of a threatened abortion. Chronic illness such as diabetes and thyroid disease can also increase the risk. Extremes of weight are associated with increased abortion risks. Maternal lifestyle choices including alcohol, tobacco, and illicit drug use have also been linked to threatened abortions.

Investigations

  • Haemogram and blood group
  • Blood slide for malaria parasites in endemic malarious areas
  • Urinalysis and microscopy
  • Ultrasound examination to exclude “Blighted Ovum” or hydatidiform mole, and is reassuring if normal intrauterine pregnancy is seen
  • VDRL

Management

  • Order bed rest at home or in facility.
  • For pain, offer hyoscine butylbromide 20mg TDS and/or paracetamol 1g TDS for 5 days.
  • Sedate with phenobarbitone 30mg TDS for 5 days OR diazepam 5mg TDS for 5 days, to help allay anxiety and enforce bed rest.
  • Evacuate uterus if more bleeding and signs of progression to incomplete
    abortion occur.

Patient Education

  • If on bed rest at home, return to health facility if features of progression to incomplete abortion intensify, e.g., more bleeding.
  • Abstain from sexual intercourse for at least 2 weeks to prevent progression to incomplete abortion and risk of infection.