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At least 19 recordsLinked to original sources
PubMed1996

Management of threatened abortion.

Threatened abortion is associated with bleeding and/or uterine cramping while the cervix is closed. This stage of abortion may progress to spontaneous incomplete or complete abortion. While this event may be considered a part of the quality control process in human reproduction, it is important to know the possible etiologies and when therapy might prevent pregnancy loss. The World Health Organization estimated that 15% of all clinically recognizable pregnancies and in spontaneous abortion, 50-60% of which are due to chromosomal abnormalities. Apart from the fetal factors, several maternal and probably paternal factors contribute to the causes of spontaneous abortion. The maternal factors that may be responsible for abortion include both local and systemic conditions such as infections, maternal disease states, genital tract abnormalities, endocrine factors and other miscellaneous causes (antiphospholipid antibodies, maternal-fetal histocompatibility, excessive smoking and other environmental toxicants, etc.). This review focuses on the management of threatened abortion, but it should be emphasized that the management to maintain pregnancy is reasonable only in those cases, in which the fetus is not seriously affected. It would not be beneficial to provide treatment that would permit chromosomally and anatomically abnormal embryos to survive to term. Treatment is feasible first of all in cases with maternal factors. Surgical procedures may precede pregnancy (correction of septate uterus, removal of a submucous leiomyomata) or may be performed usually in the second trimester (cervical cerclage). Maternal general diseases (diabetes, hypothyroidism) and infections should be treated accordingly. The most common entity to be treated in this category is luteal phase deficiency. Progesterone is the most important hormone for the maintenance of an early human pregnancy. Besides progesterone administration, human chorionic gonadotropin (hCG) also is the logical endocrine treatment of choice. In the pregnant woman hCG stimulates and optimizes hormonal production in the corpus luteum and may also influence the fetoplacental unit. The contribution of environmental, physical and chemical agents to the incidence of spontaneous abortion is controversial. They may be abortifacient even if they are not teratogenic. Exposure to environmental toxicants should be avoided. Paternal leukocyte immunotherapy has been associated with successful outcome in patients with unexplained repeated spontaneous abortion. This therapeutic approach is considered experimental, as there may be some significant risks. Associating maternal antiphospholipid antibodies with reproductive failure is a rapidly developing field. Administration of corticosteroids with low doses of aspirin has resulted in fetal salvage in women in whom antiphospholipid antibodies are present.

Abortion, Spontaneous↗
PubMed1999

Miscarriage prevention tea affects plasma beta-endorphin concentrations in women with early threatened abortions.

Twenty threatened abortive patients in the 7-8th week of gestation were treated with a classical miscarriage prevention tea (Shou-Tai-Tang) combined with psychological consultation. All of the patients had a history of unexplained recurrent abortions. This treatment succeeded in sixteen out of 20 patients. The plasma concentrations of beta-endorphin (beta-EP), gonadotrophin releasing hormone (GnRH), human chorionic gonadotrophin (hCG), and progesterone (P4) were measured by radioimmunoassay before and after treatment. Compared to control subjects, beta-EP levels were significantly higher, while GnRH, hCG, and P4 were lower than before treatment. Concentrations of these peptides/hormones returned to normal ranges after successful treatment.

Abortion, Spontaneous↗
PubMed1976

[Contribution to the treatment of threatened abortion].

460 cases of threatened abortion were divided into 3 different treatment categories. Group A was treated with a combined antihistamine and antispasmodic, and Group B with tranquilizers and synthetic gestagens. Group C consisted of patients who refused therapy. The percentage of delayed abortions in group A was 79.3%, in group B 84.7% and in group C 54.8%. According to the x2-test, the difference between the treated and untreated groups is statistically significant. The mode of action of the prescribed drugs is substantiated and their effectiveness was compared with published data on other therapies. Complications of pregnancy, at delivery and during the puerperium were not more prevalent than in normal pregnancies. However, the percentage of premature births (22.9%) and of perinatal mortality (5.4%) was strikingly high. Accordingly, successfully treated threatened abortions are to be followed up as "risk" pregnancies and closely supervised as such. It is especially important to avoid a premature birth. The frequency of congenital defects and functional disturbances was 11.9%; their existence is independent of the type of therapy. Since the defects are usually of minor consequence and reversible, we advocate treatment of the threatened abortion.

Abortion, Threatened↗
PubMed2005

The impact of dydrogesterone supplementation on hormonal profile and progesterone-induced blocking factor concentrations in women with threatened abortion.

PROBLEM: The therapeutic value of progestogens in threatened abortion is still under debate. In the presence of sufficient progesterone levels during pregnancy, lymphocytes synthesize a mediator [progesterone-induced blocking factor (PIBF)] that is anti-abortive in mice. The aim of this study was to evaluate the effect of dydrogesterone on pregnancy outcome of threatened aborters. METHOD OF STUDY: Twenty-seven threatened aborters were treated for 10 days with dydrogesterone (30-40 mg/day). Sixteen healthy pregnant controls received no treatment. Serum progesterone and estradiol concentrations as well as urine PIBF concentrations were measured by enzyme-linked immunosorbent assay (ELISA). RESULTS: Pregnancy outcomes in dydrogesterone-treated threatened aborters did not statistically differ from those in healthy controls. Serum progesterone concentrations in control patients, but not those in threatened aborters increased as pregnancy progressed. Following dydrogesterone treatment, initially low PIBF concentrations of threatened aborters significantly increased (P = 0.001) to reach the PIBF level found in healthy controls. CONCLUSIONS: These data suggest that by inducing PIBF production, dydrogesterone might improve pregnancy success rates in threatened aborters.

Abortion, Threatened↗
PubMed1980

Therapeutic value of indomethacin in threatened abortion.

One hundred cases of threatened abortion were randomly allocated to four lines of treatment namely, long acting progesterone, antispasmodic, indomethacin and placebo. The lowest success rate was encountered in the indomethacin treated group; symptoms of intolerance were common and three cases out of sixteen turned into missed abortion. Indomethacin does not offer any advantage over other lines of treatment in threatened abortion.

17 alpha-Hydroxyprogesterone Caproate↗
PubMed1994

Birth defects in relation to threatened abortion.

The evidence for the association between threatened abortion and birth defects is limited and inconsistent. This study examined this relation using data from the Shanghai Birth Defects Monitoring Program. A total of 1,013 cases of birth defects and an equal number of controls were analyzed. Our study showed that women with threatened abortion had a 50% higher risk of having a baby with birth defects compared with those without this complication, controlling for other factors (adjusted odds ratio = 1.5; 95% confidence interval = 1.1-2.1). Threatened abortion was generally related to defects of the urogenital system, heart and circulatory system, and musculoskeleton and limbs and was specifically associated with polydactyly, undescended testicle, and hypospadias.

Abortion, Threatened↗
PubMed1982

Correlation between hormonal levels and ultrasound in patients with threatened abortion.

96 women with threatened abortion were monitored by repeated ultrasonic examinations. Simultaneously plasma HCG, progesterone, estradiol and estriol levels were measured. 12 patients with blighted ovum had hormonal levels in the low normal range before the 8th week and abnormal values after the 10th week. 31 patients had abnormal ultrasonic morphology and absence of fetal heart movements. In half of these patients, estradiol was low even before vaginal bleeding. When vaginal bleeding occurred, all subjects who aborted later, except 1, had at least one abnormal hormonal value. In 4 cases, fetal life signs were detected only after the 10th week; hormonal levels remained normal, confirming the presence of a viable fetus. 31 patients had normal ultrasounds despite vaginal bleeding and arrived to term. Hormonal profiles were also normal. 18 patients had normal ultrasounds and aborted in the second trimester of pregnancy. Some of them had low normal hormonal levels. Others had a secondary decrease in hormonal levels (most often estrogen levels) which, in some cases, preceded the abnormality of the ultrasounds. It is concluded that ultrasounds and hormonal measurements are complementary. Ultrasounds alone gave a correct prognosis in 78% of the cases after a single examination. Caution is advised when fetal life signs are absent and termination of pregnancy is contemplated. Hormonal measurements may then confirm or refute the unfavorable prognosis. Also, hormonal measurements may provide some insight as to the subsequent evolution of a threatened pregnancy, even in the presence of normal ultrasounds. The therapeutic prospect of this knowledge is, however, still to be defined.

Abortion, Spontaneous↗
PubMed1989

Prognostic potential of serum CA125 and pregnant markers in threatened abortion.

To predict the outcome of patients with threatened abortion at an early stage of gestation is clinically important. CA125 and nine hormones associated with pregnancy were measured from 4 to 12 weeks of gestation in 256 pregnant women with threatened abortion. The nine hormones were: serum human chorionic gonadotropin beta-subunit, serum progesterone, serum cortisol, serum human placental lactogen, serum estrone, serum estradiol, serum estriol, urine human chorionic gonadotropin and urine estrogen. Ultrasonographic examination was also performed from 6 to 12 weeks of gestation. Of the 256 patients, 90 aborted and 166 carried to term. We found that changes in CA125 in patients with threatened abortion differed from those of the nine hormones. At 4 to 8 weeks of gestation the mean value for serum CA125 in patients with successful outcome was significantly higher than that in patients who aborted. Although ultrasonographic examination is effective after 8 weeks of gestation, serum CA125 measurement is useful in predicting early abortion.

Abortion, Threatened↗