First trimester bleeding and pregnancy outcome

Authors

  • Pradnya Digambar Kamble Department of Obstetrics and Gynecology, LokmanyaTilak Municipal Medical College, Mumbai, Maharashtra, India
  • Amarjeetkaur Bava Department of Obstetrics and Gynecology, LokmanyaTilak Municipal Medical College, Mumbai, Maharashtra, India
  • Mansi Shukla Department of Obstetrics and Gynecology, LokmanyaTilak Municipal Medical College, Mumbai, Maharashtra, India
  • Y. S. Nandanvar Department of Obstetrics and Gynecology, LokmanyaTilak Municipal Medical College, Mumbai, Maharashtra, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20171414

Keywords:

Abortions, First trimester bleeding, Preterm labor, Threatened abortion

Abstract

Background: The outcome of first trimester vaginal bleeding is a matter of debate. This study sought to determine the maternal and perinatal outcome in patients presenting with first trimester vaginal bleeding.

Methods: This prospective observational study was done on 1007 women with first trimester vaginal bleeding at a tertiary care hospital in Mumbai over a period of one year. A detailed history was taken and USG was done to confirm diagnosis. All these patients were evaluated for the outcomes including  threatened abortions, spontaneous, complete or incomplete abortions, sub-chorionic hematoma, Intra-uterine Fetal Demise, missed abortions, second and third trimester bleeding, Intra-uterine Growth Restriction, premature rupture of membranes and preterm deliveries.

Results: Out of the 11835 confinements 1007 patients presented with first trimester vaginal bleeding. The incidence was highest (52.3%) in the age group of 21-30 years. 63.9% primigravidas presented with first trimester bleeding as compared to 36.1% of multigravidas.  It was seen that 76.9% patients who presented before 6 weeks aborted whereas only 7% patients who presented after 10 weeks aborted. Out of the 163 patients that continued pregnancy after first trimester vaginal bleeding 1.8% had a second trimester abortion, 15.3% went into preterm labour 6.75% has premature rupture of membranes and 1.8% had antepartum hemorrhage.

Conclusions: According to the results of present study, first trimester vaginal bleeding predicts auxiliary maternal and fetal complications. Also, as the clinical intermediation has an important role in continuance of pregnancy and in reducing the fetal complications precise management and planning by physician is important.

References

Yakistiran B,Yuce T, Soylemez F. First trimester bleeding and pregnancy outcomes: case-control study. Int J Wom Health Reprod Sci. 2016;4(1)4-7.

Chhabra S. Perinatal outcome in cases with bleeding during first and early second trimester. Int J Med Health Biomed Bioengin Pharm Engin. 2014;8(1)61-6.

Agrawal S. Predicting adverse maternal and perinatal outcome after threatened miscarriage. Open J obstet Gynaecol. 2014;4:1-7.

Amirkhani Z, Akhlaghdoust M, Abedian M, Salehi GR, Zarbati N, Mogharehabed M et al. Maternal and perinatal outcomes in pregnant women with first trimester vaginal bleeding. J Fam Reprod Health. 2013;7(2):57-61.

De Sutter P. First trimester bleeding and pregnancy outcome in singletons after assisted reproduction. Hum Reprod. 2006;21(7)1907-11.

Dadkhah F, Kashanian M, Eliasi GA. Comparison between the pregnancy outcome in women both with and without threatened abortion. Early Hum Dev. 2010;86(3):193-6.

Deutchman M, Tubay AT, Turok D. First trimester bleeding. Am Fam Physician. 2009;79:985-94.

Thorstensen KA. Midwifery management of first trimester bleeding and early pregnancy loss. J Midwifery Womens Health. 2000;45:481-97.

Harlev A, Levy A, Zaulan Y, Koifman A, Mazor M, Wiznitzer A et al. Idiopathic bleeding during the second half of pregnancy as a risk factor for adverse perinatal outcome. J Matern Fetal Neonatal Med. 2008;21:331-5.

Riahinejad S, Motamedi N, Saadat N, Mostofiniya M, Toghiani A. Effect of vaginal bleeding in first trimester of pregnancy on pregnancy outcomes. J Isfahan Med School. 2011;156:1.

Saraswat L, Bhattacharya S, Maheshwari A, Bhattacharya S. Maternal and perinatal outcome in women with threatened miscarriage in the first trimester: a systematic review. BJOG. 2010;117:245-57.

Downloads

Published

2017-03-30

Issue

Section

Original Research Articles