A threatened miscarriage also called a “threatened abortion” or “threatened early pregnancy loss,” typically refers to vaginal bleeding and uterine cramping in an otherwise viable pregnancy before 20 weeks of gestation, though more commonly occurring in the first trimester. In a threatened miscarriage, the cervical os remains closed, and the fetus or embryo remains viable. Evaluation of threatened miscarriage depends on the pregnancy’s gestational age. At early gestational ages, it is essential to establish the location of the pregnancy to rule out an ectopic pregnancy, which can also present with vaginal bleeding and lower abdominal pain. Once an intrauterine pregnancy has been established, the clinician must determine the viability of the pregnancy, which is accomplished through a pelvic examination and ultrasound. If fetal cardiac activity is not seen, serial ultrasound examinations may be required to differentiate an early viable pregnancy from a pregnancy loss. Typically, threatened miscarriages are managed expectantly with close clinical monitoring. This activity for healthcare professionals is designed to enhance the learner’s competence when evaluating, implementing, and educating patients on threatened miscarriage and its management. By participating in this continuing education activity, clinicians will gain a comprehensive understanding of the risks, benefits, and monitoring parameters involved in managing threatened miscarriage, enabling them to provide evidence-based and patient-centered care.
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