To investigate the efficacy of tranexamic acid combined with phloroglucinol in fetal protection for threatened abortion and its impact on pregnancy outcome.

Patients with threatened abortion were divided into control group and treatment group according to the treatment methods. Both groups received routine fetal protection treatment. The control group was given intravenous infusion of tranexamic acid on the basis of routine treatment. The patients in the treatment group were additionally given intravenous infusion of phloroglucinol on the basis of the treatment of the control group. The clinical efficacy, remission time of clinical symptoms, uterine hemodynamics, sex hormone levels, pregnancy outcomes, and safety evaluation of the two groups were assessed.

A total of 82 cases were enrolled in this study, including 39 cases in the control group and 43 cases in the treatment group. The fetal protection success rates were 71.79% and 90.70% in the control and treatment groups, respectively, with statistically significant difference (P<0.05). The waist soreness relief time was (3.64±0.71) d in the control group and (3.26±0.62) d in the treatment group; the lower abdominal dragging pain relief time was (2.90±0.50) d and (2.65±0.53) d, respectively; and the vaginal bleeding relief time was (3.00±0.61) d and (2.72±0.59) d, respectively. After treatment, the resistance index (RI) was 0.83±0.16 and 0.76±0.14; the pulsatility index (PI) was 2.46±0.65 and 2.12±0.41, respectively; and the systolic/diastolic ratio (S/D) was 3.24±0.54 and 2.98±0.48 in the control and treatment groups, respectively. The progesterone (P) levels were (99.40±8.63) and (104.11±8.97) nmol·L^-1, respectively; the estradiol (E₂) levels were (982.73±82.77) and (1 027.18±79.41) pmol·L^-1, respectively; and the β-human chorionic gonadotropin (β-hCG) levels were (77 695.54±10 728.91) and (85 684.63±11 755.83) mIU·mL^-1 in the control and treatment groups, respectively. The abortion rates were 23.08% and 6.98%, and the term delivery rates were 61.54% and 88.37% in the two groups, respectively. The differences in the above indicators between the two groups were statistically significant (all P<0.05). During the treatment period, headache or diarrhea occurred in both groups, with total incidence rates of 7.69% and 4.65%, respectively, and the difference was not statistically significant (P>0.05).

The combined use of tranexamic acid and phloroglucinol in patients with threatened abortion can accelerate the relief of clinical symptoms, improve the success rate of fetal protection, and improve pregnancy outcomes, with no significant increase in adverse events observed.