THREATENED ABORTION

• Bleeding and cramping in the first 20 weeks with a live fetus.
• Incidence = 20-25% of all pregnancies.
• Clinical findings:
• Mild bleeding
• Cramping
• Closed cervix.
• Prognosis:
• 50% develop normally
• 50% abort spontaneously.

ULTRASOUND

• Plays an important role in evaluating bleeding patients as bhCG levels do not correlate well with a specific diagnosis (1,2).
• Poor prognostic factors:
• Early bradycardia.
• Large subchorionic hematoma.
• Relative fetal inactivity.

CAUSES OF FIRST TRIMESTER BLEEDING

WITH AN INTACT INTRAUTERINE PREGNANCY

1. Subchorionic hematoma.
2. Vanishing twin pregnancy.
3. Placenta covering the internal os.
4. Bleeding, degenerating fibroids.
5. Partial molar pregnancy.
6. Post removal of an intrauterine contraceptive devise.

REFERENCES

1. Hertz JB. Diagnostic procedures in threatened abortion. Obstet Gynecol 1984;66:223.
2. Jouppila P, Huhtaniemi I, Tapanainen J. Early pregnancy failure: study by ultrasonic and hormonal methods. Obstet Gynecol 1980;55:42.