时间标签：数据日期 2026-10-31 · 生成时间 2026-11-01 05:30（Asia/Shanghai）｜ 检索窗口 PubMed edat 2026/10/28–2026/10/31 ｜ 情报发生日期 2026-10-31
研究问题
Strict bed rest was historically recommended; however, high-quality evidence does not support its effectiveness in preventing progression to miscarriage.；Progesterone supplementation remains the cornerstone of treatment, with commonly used agents including progesterone and dydrogesterone, which are believed to maintain pregnancy by improving luteal function and stabilizing the endometrium.；However, the evidence supporting these strategies remains limited and, in some cases, controversial, with a lack of high-quality studies to establish definitive efficacy.
方法
Clinical guidelines, systematic reviews, meta-analyses, randomized controlled trials, and cohort studies relevant to the treatment of threatened miscarriage were included.；Data were extracted using a predefined structured form covering study design, study population, sample size, intervention and comparator, treatment outcomes, adverse events, and major limitations.；Given the narrative nature of this review and the substantial heterogeneity among the included studies in populations, interventions, and outcome measures, no quantitative synthesis or additional statistical analysis was performed.
核心结论
Threatened miscarriage is a clinical syndrome characterized by vaginal bleeding before 20 weeks of gestation, with or without lower abdominal pain, in the presence of a closed cervix, no expulsion of pregnancy tissue, and ultrasonographic confirmation of an ongoing intrauterine pregnancy with embryonic or fetal viability., Vaginal bleeding occurring after 20 weeks of gestation is generally classified as either antepartum hemorrhage or threatened preterm labor.；Beyond the substantial psychological burden, including anxiety, depression, and post-traumatic stress disorder, threatened miscarriage is also associated with an increased risk of adverse pregnancy outcomes, such as preterm birth, placenta previa, and postpartum hemorrhage.；It is important to note that a large amount of available clinical data is derived directly from patient cohorts with threatened miscarriage, and some clinical management recommendations are extrapolated from studies of recurrent pregnancy loss, recurrent implant failure, or threatened preterm birth, which may prevent such protocols from being directly applic ‖ 结论：In conclusion, threatened miscarriage is characterized by marked etiological heterogeneity, and treatment responses vary substantially across different patient populations.
局限
In conclusion, threatened miscarriage is characterized by marked etiological heterogeneity, and treatment responses vary substantially across different patient populations.；If dydrogesterone is used, inform the patient of its limitations.
对本项目的价值
★☆☆☆☆ 干预证据决定参照标准效应量——任何抗衰干预的收益至少应对标该基线。设计 multi-omics、randomized controlled trial、systematic review。
全文来源
PMC JATS 全文（正文 41,408 字符，已过标题/DOI 逐字归属校验）
原文题录
- 英文标题：Threatened Miscarriage: Evidence-Based Status and Advances in Western Medical Treatments.
- 期刊与标识：Int J Womens Health · PMID 42953783 · DOI 10.2147/ijwh.s638716
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