Holistic Approaches to Treating Early Pregnancy Bleeding: Evaluating Medical, Surgical, and Lifestyle Interventions in Diverse Patient Populations with Threatened Miscarriage and Ectopic Pregnancy

Abstract

Early pregnancy bleeding (EPB) – bleeding within the first trimester – affects roughly 20–30% of pregnancies and is a major source of anxiety for women, with nearly half of affected pregnancies ultimately miscarrying. Common causes include threatened miscarriage and ectopic pregnancy, each requiring distinct management strategies. A holistic approach addressing both clinical and emotional needs is needed. Objective: This study evaluated the effectiveness of a holistic management model for EPB by comparing outcomes of medical, surgical, and lifestyle interventions. Methods: We conducted a retrospective observational cohort study of women (n = 150) presenting with EPB (<14 weeks’ gestation) at a tertiary care center. Patients were managed with progesterone supplementation (for threatened miscarriage), laparoscopic intervention (for ectopic pregnancy), and standardized lifestyle counseling. Primary outcomes included pregnancy continuation, complication rates, and patient-reported anxiety and satisfaction. Data were analyzed using SPSS (independent t-tests, chi-square tests; p < 0.05). Results: Among threatened miscarriage patients, those receiving progesterone (n = 50) had significantly higher rates of ongoing pregnancy (80% vs. 60%, p = 0.01) and reported lower mean anxiety scores (3.2 vs. 5.8, p < 0.001) and greater satisfaction than controls. In the ectopic pregnancy cohort, laparoscopic management (n = 30) resulted in rapid resolution (mean hospital stay ~1.2 days vs. 14.3 days for medical management, p < 0.001) with minimal complications; patient satisfaction was slightly higher in the surgical group. Women who adopted recommended lifestyle modifications reported better emotional outcomes, consistent with existing literature. Conclusions: A multidisciplinary, patient-centered approach to EPB – combining progesterone therapy, timely surgical care, and supportive lifestyle counseling – improves both clinical and psychosocial outcomes. These findings underscore the need for integrated care models that address the full spectrum of patient needs during early pregnancy complications.