threatened miscarriage

Threatened miscarriage (or threatened abortion) is mainly a clinical term, used when a pregnant woman in first 20 weeks of gestation presents with spotting, mild abdominal pain and contractions, with a closed cervical os .

Epidemiology

It occurs in 20-25% of pregnancies and is associated with an increased rate of fetal loss (15-50%, compared to 2-7%).

Radiographic features

Ultrasound

Cervix is closed, and there is a live intrauterine gestation.

In many cases, the ultrasound will be either completely normal, or with a subchorionic hemorrhage.

Some features suggestive of a poor outcome:

• fetal bradycardia: <80-90 bpm
• small mean gestational sac diameter 
• large and calcified yolk sac of more than 7 mm
• small or irregular gestational sac: MSD/CRL <5 mm
• large subchorionic hemorrhage more than 2/3 of gestational sac
• expanded amnion sign (an abnormally large amniotic cavity)
• absent or poor decidual reaction

Treatment and prognosis

Threatened miscarriage can go on to become any of:

• normal pregnancy ~50%
• inevitable miscarriage
• incomplete miscarriage
• complete miscarriage
• missed miscarriage

Siehe auch:

• Abortus completus
• gestational sac
• Fehlgeburt
• CRL
• verhaltener Abort
• Abortus incompletus
• MSD
• unvermeidliche Fehlgeburt
• subchorionic hemorrhage
• fetal bradycardia

und weiter:

• obstetric curriculum
• first trimester
• embryonal demise
• differential diagnosis for bleeding in pregnancy