What tests are needed for threatened abortion?

Due to environmental pollution and some physiological and psychological changes in women during pregnancy, threatened abortion during pregnancy is very common, so the examination and treatment of threatened abortion is very necessary and important. So what kind of examination is needed for threatened abortion? Let me give you a detailed answer below.

The diagnosis can be made based on the medical history and clinical manifestations. Sometimes, it is necessary to combine gynecological examination, B-ultrasound, blood hCG and other physical examinations or auxiliary examinations to make a clear diagnosis and classify the types of miscarriage. For early pregnancy, especially threatened miscarriage not long after menstruation, the main purpose is to observe the possibility of continuing pregnancy. The main auxiliary diagnostic methods are B-ultrasound and blood hCG level detection.

Through vaginal B-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; through abdominal B-ultrasound, 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 is seen but the fetus is not seen for a long time, or there is a fetal bud 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 ultrasound examinations in early pregnancy and shorten the waiting time, pregnancy tests and blood progesterone level measurements can be performed.

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

In early pregnancy, the level of hCG β subunit in the blood should continue to increase, and its doubling time is about 2 to 3 days, that is, its value doubles every 3 days or so. Therefore, the level of hCG β subunit in the blood can be measured again after 3 days to understand the development of the fetus. If the measured level of hCG 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 test for human chorionic gonadotropin in blood or urine 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.