I was diagnosed with a threatended abortion. if a miscarriage is indeedhappenning, how much longer after the threat will it happen? If i was bleedingwith bad cramps for a couple of days, and the miscarriage still did not happen,should i be more hopeful?

	Asked by besimcha (Female; 23 ) on Thu 29, Apr 2010 04:49am :
	I was diagnosed with a threatended abortion, being 7 weeks pregnant if a miscarriage is indeed happenning, how much longer after the threat will it happen? If i was bleeding with bad cramps for a couple of days, and the miscarriage still did not happen, should i be more hopeful? the blood test revealed that my hcg level is normal for the size of the baby. when will i know if a miscarriage will actually occur?
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	Answer by Dr.Kokil Mathur (doctor) on Thu 29, Apr 2010 06:53am: Hi! Thanks for the question on the forum. Bleeding and cramps in the first trimester of pregnancy can really scare a woman. However the good news is that most women who have threatened abortion with symptoms of bleeding and cramps actually go on to have a normal pregnancy. It may happen in your case too especially since the HCG levels are normal for the duration of pregnancy. You should meanwhile restrain from strenuous activities and take life easy. Most couples are advised to refrain from sexual activities until the symptoms settle down. You and the gynecologist will closely monitor the blood loss (in terms of the number of pads or tampons soaked), cramps and repeat the HCG levels. If the HCG levels keep rising, then an ultrasound may be done after a week or two once the cramps and bleeding settle to look at the baby. Generally if the abortion is to occur, it can occur any time and at 7 weeks will only consist of a heavy flow with clots and tissues. It is difficult to predict when an abortion will occur. However, if the cramps reduce and the bleeding stops, there is every chance you will be able to carry the pregnancy forward. Let’s keep our fingers crossed! Hope this helps. Please let me know if there is any thing else and do keep me posted. Take care! Please rate my answer (select the stars below, no need to log in.)
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	Comments: Comment by Dr J Singh on Thu 29, Apr 2010 09:51pm: Hello, Welcome to the forum and thanks for posting on it. Dr Kokil has explained the condition very well. I agree with her that you should keep a regular tab on your HCG levels. Fortunately this risk of threatened abortion is more in the first trimester or in the first 12 weeks of pregnancy. One of the articles of pubmed beautifully states the causes which may be associated with threatened abortion and these 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.). Besides the lifestyle measures stated by Dr Kokil like rest, good diet, abstinence from intercourse, sleeping in the left lateral position, 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. But these two are given only if you are deficient in them. So keep a close watch on the amount of blood loss and if it is heavy then you can talk to your doctor about these treatment options. I hope it helps. Take care and please do keep us posted in case you have any additional doubts. Kind regards.
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