Prognosticating First Trimester Vaginal Bleeding: A Case-Control Study Of Obstetric Outcome In A Tertiary Care Center
DOI:
https://doi.org/10.52783/jns.v14.2766Keywords:
Threatened miscarriage, first trimester, preterm delivery, subchorionic bleedingAbstract
Aims And Objectives: To evaluate the impact of first-trimester vaginal bleeding as a predictor of adverse pregnancy outcomes.
Material And Methods: A case-control study was conducted for a year, comprising of 80 cases and controls. The cases and controls were followed up and obstetric outcomes were noted which includes missed/complete/incomplete abortion, preterm delivery, premature rupture of membrane (PROM), preterm premature rupture of membrane (PPROM), IUGR, manual removal of placenta, preeclampsia, abruption placenta, placenta previa were tabulated and statistical analysis performed.
Results: Incidence of first trimester vaginal bleeding was 18-20%. Overall, subjects with first trimester bleeding had statistically significant higher risk of preterm delivery [8.75% vs. 1.25%;OR-7.57;P value:0.030], PROM [15% vs. 5%;OR-3.53;P value:0.035], PPROM [8.75% vs. 1.25%;OR-7.57;P value:0.03], abortion [20% vs. 2.5% ;OR- 8.75;P value:0.002]. IUGR [3.75% vs. 2.5%;OR-1.52], pre-eclampsia [5% vs. 2.5%;OR- 2.05], abruption placenta [2.5% vs 1.25%;OR-2.03], manual removal of placenta [5% vs.1.25%;OR-4.15] were not statistically significant. Similarly there was no statistically significant difference in the cesarean section (47.6% vs 47.7%) and vaginal delivery (50.8% vs 52% ) in both groups.All babies had normal APGAR.
Conclusion: In the present study, 80% of the subjects continued their pregnancy despite having had threatened abortion in the first trimester. It was found that there was an increased risk of preterm delivery, PROM, PPROM , and abortion which was significant.
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Wittels KA, Pelletier AJ, Brown DF, Camargo Jr CA. United States emergency department visits for vaginal bleeding during early pregnancy, 1993-2003. American journal of obstetrics and gynecology. 2008;198(5):523. e1-. e6.
James DK, Steer PJ, Weiner CP, Gonik B, Robson SC. High-risk pregnancy: management options: Cambridge University Press; 2017.
Sharami SH, Darkhaneh RF, Zahiri Z, Milani F, Asgharnia M, Shakiba M, et al. The relationship between vaginal bleeding in the first and second trimester of pregnancy and preterm labor. Iranian journal of reproductive medicine. 2013;11(5):385.
Magnus MC, Wilcox AJ, Morken N-H, Weinberg CR, Håberg SE. Role of maternal age and pregnancy history in risk of miscarriage: prospective register based study. bmj. 2019;364.
Weiss JL, Malone FD, Vidaver J, Ball RH, Nyberg DA, Comstock CH, et al. Threatened abortion: a risk factor for poor pregnancy outcome, a population-based screening study. American journal of obstetrics and gynecology. 2004;190(3):745-50.
Poulose T, Richardson R, Ewings P, Fox R. Probability of early pregnancy loss in women with vaginal bleeding and a singleton live fetus at ultrasound scan. Journal of obstetrics and gynaecology. 2006;26(8):782-4.
Heller HT, Asch EA, Durfee SM, Goldenson RP, Peters HE, Ginsburg ES, et al. Subchorionic hematoma: correlation of grading techniques with first‐trimester pregnancy outcome. Journal of Ultrasound in Medicine. 2018;37(7):1725-32.
Hashem A, Sarsam SD. The impact of incidental ultrasound finding of subchorionic and retroplacental hematoma in early pregnancy. The Journal of Obstetrics and Gynecology of India. 2019;69(1):43-9.
Nishimura F, Mogami H, Moriuchi K, Chigusa Y, Mandai M, Kondoh E. Mechanisms of thrombin-Induced myometrial contractions: Potential targets of progesterone. Plos one. 2020;15(5):e0231944.
Johns J, Hyett J, Jauniaux E. Obstetric outcome after threatened miscarriage with and without a hematoma on ultrasound. Obstetrics & Gynecology. 2003;102(3):483-7.
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: An International Journal of Obstetrics & Gynaecology. 2010;117(3):245-57.
Samarakkody S, Gunawardena K. A prospective cohort study to assess the association between early pregnancy bleeding and risk of poor pregnancy outcome. Sri Lanka Journal of Obstetrics and Gynaecology. 2019;41(1).
Di Renzo GC, Giardina I, Clerici G, Brillo E, Gerli S. Progesterone in normal and pathological pregnancy. Hormone molecular biology and clinical investigation. 2016;27(1):35-48.
Czyzyk A, Podfigurna A, Genazzani AR, Meczekalski B. The role of progesterone therapy in early pregnancy: from physiological role to therapeutic utility. Gynecological Endocrinology. 2017;33(6):421-4.
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