Obstetric outcome of antenatal mother with history of spontaneous abortion attending a tertiary care hospital in Puducherry
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20231203Keywords:
Preterm delivery, PROM, Recurrent pregnancy loss, Spontaneous abortionAbstract
Background: The pregnancy time is critical for both the mother’s and the baby’s health. The most common unfavourable pregnancy outcome is spontaneous abortion. Spontaneous pregnancy loss is a surprisingly common event, with roughly 15% of all clinically diagnosed pregnancies ending in pregnancy failure. Couples who suffer from frequent miscarriages may find it difficult to cope physically and emotionally. This study was planned to evaluate the association of preterm delivery, low birth weight, IUGR, recurrence of abortion, still birth, IUD, PROM, or any other adverse outcome in patients with history of previous spontaneous abortions. Objectives were to look for association between previous spontaneous abortion and preterm delivery, low birth weight, IUGR, recurrence of abortion, stillbirth, IUD, PROM and other complications in subsequent pregnancies.
Methods: This was a prospective observational study done with 150 samples. The information such as demographic data of the antenatal women, clinical history, past obstetrics history, clinical examination, laboratory investigations and outcome of present pregnancy were collected and evaluated.
Results: Maternal complications such as UTI (4.6%), Infection and fever (5.3%), PROM (2.7%), PPH (4%), hyperemesis 4%, PPROM 2.7% were observed. In study population, 60% of the foetus were in cephalic position, 19% in breech presentation and 21% in shoulder presentation. 29% of the women had preterm delivery, 34% were delivered by LSCS and 6% had spontaneous abortions. Low birth weight babies delivered in 25% cases. Foetal distress was observed in 15%, FGR in 9%, still birth in 3% and IUD in 1%.
Conclusions: Women with previous spontaneous abortion are associated with a higher incidence of preterm delivery, cesarean section rate, neonatal low birth weight, fetal distress and high possibility of infection. Therefore, patients with previous spontaneous miscarriage represent a high-risk population for obstetric complication and close surveillance during the antenatal period is required.
References
WHO: recommended definitions, terminology and format for statistical tables related to perinatal period. Acta Obstet Gynecol Scand. 1977;56:247-53.
Brigham SA, Conlon C, Farquharson RG. A longitudinal study of pregnancy outcome following idiopathic recurrent miscarriage. Hum Reprod. 1999;14:2868-71.
Paz JE, Otano L, Gadow EC, Castilla EE. Previous miscarriage and stillbirth as risk factors for other unfavourable outcomes in the next pregnancy. Int J Obstet Gynecol. 1992;99(10):808-12.
Kline J, Stein Z. Spontaneous abortion (miscarriage). In: Bracken MB, ed. Perinatal Epidemiology. New York: Oxford University Press; 1984:23-51.
Whitcomb BW, Schisterman EF, Klebanoff MA, Baumgarten M, Luo X, Chegini N. Circulating levels of cytokines during pregnancy: thrombopoietin is elevated in miscarriage. Fertil Steril. 2008;89(6):1795-802
Farquharson RG, JauniauxE, Exalto N; ESHRE Special Interest Group for Early Pregnancy (SIGEP). Updated and revised nomenclaturefor description of early pregnancy events. Hum Reprod. 2005;20(11):3008-11.
Zhou H, Liu Y, Liu L, Zhang M, Chen X, Qi Y. Maternal pre-pregnancy risk factors for miscarriage from a prevention perspective: a cohort study in China. Eur J Obstet Gynecol Reprod Biol. 2016;206:57-63.
Nery IS, Gomes IS. Motives and feelings of women about miscarriage Methodology Theoretical Reference. Nurse Obstet. 2014;1(1):19-24.
Diejomaoh MFE. Recurrent spontaneous miscarriage is still a challenging diagnostic and therapeutic quagmire. Med Princ Pract. 2015;24(1):38-55.
O’Dwyer V, Monaghan B, Kennelly MM, Turner MJ, Farah N. Miscarriage after sonographic confirmation of an ongoing pregnancy in women with moderate and severe obesity. Obes Facts. 2012;5:393-8.
Hure AJ, Powers JR, Mishra GD, Herbert DL, Byles JE, Loxton D. Miscarriage, preterm delivery, and stillbirth: large variations in rates within a cohort of australian women. PLoS One. 2012;7(5):1-8.
Parveen F, Shukla A, Agarwal S. Cytokine gene polymorphisms in northern Indian women with recurrent miscarriages. Fertil Steril. 2013;99(2):433-40.e2.
Kazerooni T, Ghaffarpasand F, Asadi N, Dehkhoda Z. Correlation between thrombophilia and recurrent pregnancy loss in patients with polycystic ovary syndrome: a comparative study. J Chinese Med Assoc. 2013;76(5):282-8.
Tang AW, Alfirevic Z, Quenby S. Natural killer cells and pregnancy outcomes in women with recurrent miscarriage and infertility: a systematic review. Hum Reprod. 2011;26(8):1971-80.
Jivraj S, Anstie B, Cheong YC, Fairlie FM, Laird SM, Li TC. Obstetric and neonatal outcome in women with a history of recurrent miscarriage: a cohort study. Hum Reprod. 2001;16(1):102-6.
Agrawal S, Khoiwal S, Jayant K, Agarwal R. Predicting adverse maternal and perinatal outcome after threatened miscarriage. J Obstet Gynecol. 2014;04(01):1-7.
Kashanian M, Akbarian AR, Baradaran H, Shabandoust SH. Pregnancy outcome following a previous spontaneous abortion (miscarriage). Gynecol Obstet Investig. 2006;61(3):167-70.
Nehal N, Sawant V. Pregnancy outcome following previous history of spontaneous abortion. Obset Rev J Obstet Gynecol 2019;5(1):53-8.
Nelson DB, Bellamy S, Nachamkin I, Ness RB, Macones GA, Allen-Taylor L. First trimester bacterial vaginosis, individual microorganism levels, and risk of second trimester pregnancy loss among urban women. Fertil Steril. 2007;88(5):1396-403.
Agrawal S, Khoiwal S, Jayant K, Agarwal R. Predicting adverse maternal and perinatal outcome after threatened miscarriage. J Obstet Gynecol. 2014;04(01):1-7.
