Treatment is carried out both in the process of gestation and outside it. Therapeutic measures during pregnancy are aimed at preventing premature expulsion of the fetus, maintaining its further development. Outside the gestation period, correction of pathological changes leading to miscarriage is carried out using methods that cannot be applied during pregnancy.
Symptomatic treatment of threatened and incipient miscarriage includes bed rest, sedative, antispasmodic and hemostatic drugs, in case of premature birth, tocolytic agents are additionally used. With ICI, the external cervical os is sutured or a pessary ring is installed. In the case of a missed pregnancy and incomplete abortion, curettage is performed; in the later stages, the expulsion of the fetus is carried out by excitation of the contractile activity of the uterus. Methods of etiotropic treatment depend on the cause of the pathology:
• Hormone therapy. In case of ovarian insufficiency, leading to a deficiency of the corresponding hormones, estrogen, progesterone, chorionic gonadotropin preparations are prescribed; in case of impaired adrenal function, APS, and other autoimmune processes - glucocorticoids; in case of hypothyroidism - thyroxine preparations.
• Antithrombotic treatment. Produced with established genetically determined thrombophilia, APS. Low molecular weight heparins, antiplatelet agents are used, with hyperhomocysteinemia - vitamins B6, B12, folates. Outside of pregnancy, long-term use of indirect anticoagulants is indicated.
• Antibacterial therapy. During pregnancy, it is prescribed to combat intrauterine infection in the detection of foci in the genitourinary tract, tonsillitis, chorioamnionitis, but at this stage it does not contribute to the adequate formation of the gravid endometrium and normal implantation. Treatment of endometritis to prevent pregnancy should be carried out before gestation.
• Surgery. Surgical intervention is recommended for anatomical defects, it is carried out outside of pregnancy. Metroplasty, removal of an additional uterine horn, conservative myomectomy, vaginoplasty are performed.