The treatment for a threatened abortion varies from restricting some forms of exercise to complete bed rest. Abstaining from intercourse is usually recommended until the warning signs have disappeared.

If a spontaneous abortion occurs, the signs of pregnancy decrease, the uterus begins shrinking to its original size, and a brownish or reddish vaginal discharge is often experienced. The tissue passed from the vagina should be examined to determine the source (fetal vs. hydatidiform mole). It is also important to determine whether any fetal tissue remains in the uterus. This is called an incomplete spontaneous abortion.

If remaining tissue is not naturally aborted in a reasonable amount of time (about 4 weeks), surgery (D and C or D and E) or medication will be required to complete the abortion. Medications include mifepristone, methotrexate, misoprostol, or a combination of these medications. Most women who use these medications do so because of a desire to avoid anesthesia and surgery if at all possible.

Side effects of the medication may include nausea, vomiting, diarrhea, warmth or chills, headache, more visits to the doctors office, prolonged vaginal bleeding, and being more aware of cramping than with surgical abortion. With medication, passage of the products of conception most likely will occur at home, but some women may still require surgical evacuation (D and E) to complete the abortion. The success rate has been shown to be around 95%.

Once the tissue is removed, the woman usually resumes her normal menstrual cycle within a few weeks. Any further vaginal bleeding should be carefully monitored. It is often possible to become pregnant immediately, but the woman should usually wait for 1 or 2 normal menstrual cycles before trying to become pregnant again.

• Retained fetal tissue (an incomplete abortion) may cause an infection and must be removed surgically.
• An infection also may occur after a complete abortion.

Call your health care provider if vaginal bleeding with or without cramping occurs during pregnancy.

Call your health care provider if you are pregnant and notice tissue or clot-like material passed vaginally (any such material should be collected and brought in for examination).