What are the routine examination items for threatened abortion?

What are the routine examination items for threatened abortion? Threatened abortion is a blow that pregnant mothers do not want to face, but have to face. Fortunately, there is a chance of recovery from threatened abortion. As long as the diagnosis is confirmed in time, the fetus can be treated as soon as possible. So what are the routine examination items for threatened abortion?

1. Ultrasound examination: Through vaginal ultrasound examination, the gestational sac can be seen about 35 days after the last menstrual period, and the primitive heart tube pulsation of the fetus can be seen after 42 days; abdominal ultrasound examination, the gestational sac can be seen 35 to 42 days after the last menstrual period, and the primitive heart tube pulsation of the fetus can be seen 49 days after the last menstrual period.

Therefore, continuous B-ultrasound monitoring can be performed when threatened abortion is found. If only the gestational sac can be seen but the fetus is not seen for a long time, or the fetal bud is seen but the fetal heart is not seen for a long time, it indicates a poor prognosis. At 49 to 70 days of pregnancy, the fetal heart rate can be heard by Doppler, and the fetal heart rate can be heard from the abdomen by lifting the uterus through bimanual examination. In order to reduce the number of B-ultrasound examinations in early pregnancy and shorten the waiting time, pregnancy tests and blood progesterone level measurements can be performed.

2. Urine pregnancy test or determination of β-subunit levels in the blood: Positive urine pregnancy test: At 33-35 days after menstruation, when the gestational sac is seen by vaginal ultrasound, the β-subunit level in the blood is about 1800 milliunits/ml (mlu/ml), and it can reach 20,000-1800 milliunits/ml on 49 days. Values ​​below this generally indicate a poor prognosis.

In early pregnancy, the level of β-subunit in the blood should continue to increase, and its doubling time is about 2 to 3 days, that is, its value can double every 3 days or so. Therefore, the level of β-subunit in the blood can be measured again after 3 days to understand the development of the fetus. If the level of β-subunit in the blood does not increase significantly or even decreases, it indicates a poor prognosis for the fetus.

However, it should be known that a single positive blood or urine test does not indicate whether an embryo exists, nor can it determine whether it is an intrauterine or ectopic pregnancy. It must be measured twice to be meaningful, or combined with B-ultrasound to make a clear diagnosis.

3. Determination of blood progesterone levels: Recent studies have found that the determination of blood progesterone levels is more accurate in judging the prognosis of pregnancy. If the blood progesterone level is lower than 5 ng/ml, whether it is an intrauterine pregnancy or an ectopic pregnancy, it generally indicates that the pregnancy has died. If the blood progesterone level is higher than 25 ng/ml, it indicates that the intrauterine pregnancy is alive; if it is between 5 and 25 ng/ml, reexamination and follow-up are required.