Risk of abortion

Abortion is defined as the death of a foetus before the 20th week of pregnancy. A large number of these occur before the 12th week of pregnancy. The rate of spontaneous abortion in confirmed pregnancies is 20%.

The most common symptoms are vaginal bleeding and lower abdominal pain. It is important to note that bleeding is a common occurrence in the first trimester of pregnancy. Between 20-30% of women with a confirmed pregnancy will bleed during the first 20 weeks of pregnancy. Of these, about half will have a spontaneous abortion.

Preceding conditions and risk factors in the pregnant woman are of great importance: women older than 35 years, a history of spontaneous abortion, structural changes in the cervix, invasive prenatal tests, active smokers or with weight changes (malnutrition - obesity).

Diagnosis requires a gynaecological examination and pelvic examination to assess the intensity of the bleeding and whether the cervix is open. A transvaginal ultrasound scan should also be performed to assess the condition of the foetus.

If a pregnancy is confirmed and there is a heartbeat, this is considered a risk of abortion. If the embryo does not have a heartbeat, it is considered a failed abortion. It is useful to do a blood test to see if there is anaemia and to check the levels of beta-human chorionic gonadotropin hormone (beta-hCG).

Treatment for miscarriage is rest and constant monitoring. In some cases, the use of progesterone can reduce the risk of miscarriage. If the abortion is confirmed, a good option is continuous monitoring until spontaneous abortion occurs or uterine evacuation (pharmacological or surgical curettage).

In some cases, a spontaneous abortion can be complicated. If the foetus and placenta remain in the uterus for too long, vaginal bleeding may continue or an infection may develop. This can lead to fever, pain and sometimes even generalised septicaemia.