Published: 2017-08-28

Incidence of early pregnancy complications, management protocols and its outcome in patients at Gujarat Adani Institute of Medical Science, Bhuj, Kutch, Gujarat, India

Akansha ., Nagajan Bhadarka


Background: Early Pregnancy Complications can cause significant morbidity and mortality. Pregnant women an present with h/o amenorrhea, abdominal pain, vaginal bleeding or incidental scan finding of missed abortion, ectopic pregnancy and vesicular mole, features of hypermesis gravidorum like fatigue, nausea, vomiting, dryness and diminished urine output. The objective of present study was to analyze the incidence of various early pregnancy complications, assess the protocols for diagnosing these complications and their management.

Methods: Present study was conducted at the Department of Obstetrics and Gynecology, Gujarat Adani Institute of Medical Science, Bhuj, Kutch, Gujarat. All the women with first trimester pregnancy with different complications were included in this study while those women with uneventful first trimester were excluded. The inducted women were registered on pre-designed proforma. Studied variables including demographic details, gestational period, type of complications, risk factors, treatment and outcome.

Results: Out of 740 total admissions 439 abortions of which incomplete abortion was 262, missed abortions were 132, threatened abortion 42 and 3 cases of septic abortion, ectopic pregnancy 154, molar pregnancy33, hyperemesis 31. There were about 63 cases of non-pregnancy related complication reported during early pregnancy like 31 with UTI, 9 with renal colic, 2 cases of appendicitis, four cases of asymptomatic cholelithiasis, 2 cases of hepatitis, 5 cases of ovarian cyst complicating pregnancy, 2 cases of ovarian torsion. Their mean age was 30.8+6.8 years.

Conclusions: Study was successful in creating a confidence among trainees when following the recommended protocols as well as delivering clinical benefits to the hospital, patients and staff. Early gynecological consultation and bedside ultrasound scanning within the emergency department were key requirements for any emergency concerns.


Abortions, Gynecology, Pregnancy, Ultrasound

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Khaskheli M, Baloch S, baloch AS. Risk factors in early pregnancy complications. J Coll Physicians Surg Pak. 2010;20(11):744-7.

Dart R. Role of pelvic ultrasonography in evaluation of first trimester pregnancy. Ann Emerg Med. 1999;33:310-20.

Choi H, Blaivas M, Lambert MJ. Gestational outcome in patients with first‐trimester pregnancy complications and ultrasound‐confirmed live intrauterine pregnancy. Acad Emer Med. 2000;7(2):200-3.

Morin L, Cargill YM, Glanc P. Ultrasound evaluation of first trimester complications of pregnancy. J Obstet Gynaecol Canada. 2016;38(10):982-8.

Ganchimeg, Morisakhi, Laopaiboon. Pregnancy and childbirth outcome: A world health organization multicountry study. BJOG. 2014;121(Suppl. 1):40-8.

Why Mothers Die 1997-99. The fifth report of confldential enquiries into maternal deaths in the United Kingdom 1997-99. London: RCOG Press; 2001.

Sowter MC, Farquhar CM. Ectopic Pregnancy: An Updat.e Current Opin Obstet Gynecol. 2004;16:289-93.

Van Den Eeden SK, Shan J, Bruce C, Glasser M. Ectopic pregnancy rate and treatment utilization in a large managed care organization. Obstet Gynecol. 2005;105(5, Part 1):1052-7.

WHO/UNFPA/UNICEF/World Bank. Maternal mortality 2005. Estimates developed by WHO, UNICEF, UNFPA, and the World Bank. Geneva: The World Health Organization; 2007.

Abou Zahr C, Wardlaw T. Maternal mortality at the End of a decade: signs of progress? Bull World Health Organ. 2001;79(6):561-8.

WHO/UNFPA/UNICEF/World Bank. Reduction of maternal mortality: A joint WHO/UNFPA/UNICEF/World Bank statement. Geneva: The World Health Organization; 1999.

Ronsmans C, Filippi V. Beyond the Numbers: Reviewing Maternal Deaths and Complication to Make Pregnancy Safer. Reviewing severe maternal morbidity: learning from survivors from life-threatening complications. (Chapter 7) Geneva: World Health Organization. 2004:103-124.

Mantel GD, Buchmann E, Rees H, Pattinson RC. Severe acute maternal morbidity: a pilot study of a deflnition for a near miss. Br J Obstet Gynecol. 1998;105:985-990.

Tunçalp O, Hindin MJ, Souza JP, Chou D, Say L. The prevalence of maternal near miss: a systematic review. Br J Obstet Gynaecol. 2012;119:653-61.

Say L, Souza JP, Pattinson RC. WHO working group on Maternal Mortality and Morbidity classifications. Maternal near miss-towards a standard tool for monitoring quality of maternal health care. Best Pract Res Clin Obstet Gynecol. 2009;23:287-96.

Pattison RC, Buchmann E, Mantel G, Schoon M, Rees H. Can enquires into severe acute maternal morbidity act as surrogate for maternal death enquires? BJOG. 2003;110:889-93.

Souza J, Cecatti JG, Hardy EF, Serruya SJ, Amaral E. Appropriate criteria for identification of near miss maternal morbidity in tertiary care facilities: a cross sectional study. BMC Pregnancy Childbirth. 2007;7:20.

Waterstone M, Bewley S, Wolfe C. Incidence and predictors of severe obstetric morbidity: case control study. Br Med J. 2001;322:1084-94.

Paruk F, Moodley J. Severe obstetric morbidity. Curr Opin Obstet Gynecol. 2001;13:563-8.

Goffman D, Madden RC, Harrison EA, Merkatz IR, Chazotte C. Predictors of maternal mortality and near-miss maternal morbidity. J Perinatol. 2007;27:597-601.