Dear Safia, I understand your concerns about your sister s pregnancy. The following points should be taken into consideration : 1- vaginal spotting during the first trimester might be due to multiple reasons, but since an ultrasound was done and showed an intrauterine pregnancy then your sister has a threatened abortion. An ultrasound should be done in order to detect the fetal heart rate and make sure that the fetus is still alive. A threatened abortion carries a 50% risk of miscarriage. Hence the most important next step is to do an ultrasound to look for the fetal heart rate. 2- Regarding ecosprin, we have no data at all that it should be taken unless the obstetrical history of your sister is positive for a previous pre-eclampsia in a previous pregnancy, or in the case of recurrent abortions (not a clear evidence but some physicians like to give it especially in IVF patients). To be noted that ecosprin is a blood thinner and hence it can exacerbate bleeding. So i recommend your sister, if her obstetrical history is not significant for pre-eclampsia or for abortions, to stop ecosprin because it might worsen her symptoms and exacerbate the bleeding. 3- I think the other medication is Ovidrel. Regarding this medication, it is useless to be taken during pregnancy because the fetus is producing it is own HCG through the trophoblastic cells. In fact this medication can be misleading in case a serial B-HCG level needs to be taken in order to diagnose a failing pregnancy. Hence it is recommended to stop this medication too. I recommend your sister to do an ultrasound to make sure that the fetus is alive, if so then stop ecosprin and ovidrel, make sure that her blood group rhesus is positive ( in case her rhesus is negative and her husband rhesus is positive it is recommended to take anti-Ag D antibodies to protect subsequent pregnancies). Best regards