Fetomaternal outcome in patients with threatened abortion in the first trimester – An observational study (original) (raw)
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International Journal of Medical and Biomedical Studies, 2021
Background: The outcome of ongoing pregnancies after first trimester vaginal bleeding is of relevance to women and obstetricians for planning antenatal care and clinical interventions in pregnancy. Hence, this study was conducted to identify the risks associated with first trimester bleed which may facilitate decision making regarding mode, place and timing of delivery during management, which may improve maternal and neonatal outcome. Methods: Hospital based comparative prospective study conducted at Department of Obstetrics and Gynaecology, SMS Medical College & associated Hospitals, Jaipur. Results: APH was found in 4 (8.00%) patients of case group and nil in control group. So, APH was found to be more in the case group than control group but was statistically not significant. Pre-eclampsia was found in 4 (8.00%) in case group and 3 (6.00%) in control group with statistically insignificant difference between the two groups. 26 (52.00%) delivered at the gestational age of ?37 wee...
Background: Medical abortion is a safe, effective and affordable method of termination of pregnancy. Success rate is 92 - 97%. When performed as per guidelines. After legalisation of medical abortion in India in 2002, abortion pills are available over the counter throughout the country. This has led to unsupervised use of such method and subsequent complications. Objective:To study the demographic profile and outcomes of induced medical abortion in first trimester of pregnancy. Materials and methods: This is a hospital based prospective observational study undertaken in the department of Obstetrics & Gynaecology, S.C.B. Medical College, Cuttack during the period of one year from August 2015 to July 2016. Women between 15 to 45 years in first trimester of pregnancy admitted the department either through emergency or OPD after taking combined abortificient drugs (mifepristone & misoprostol combinations) elsewhere were included in the study. Results: Out of 123 cases 91.8% were married, 61.8% were from early reproductive age group 74.4% (20 to 30 years) are from rural area and 78.9% belongs to low socio-economic section. 91.1% women taken these drugs either through over the counter or from huregistences medical practitioner. 78.9% of women taken the drug within 9 weeks gestation (63 days). 88.6% of cases presented to the hospital with excessive vaginal bleeding and 43.9% with abdominal pain. Incomplete, complete and septic abortion was detected in 73.9%, 10.6 and 12.2 percent of cases respectively. 38.2% were detected to have severe anaemia and 57.7% moderate anemia, 47.2% needed blood transfusion, 3 (2.4%) patients expired due to anemia, sepsis, shock and ARF. Conclusions: Most of the women are young, less educated and low socio-economic status. Incomplete abortion, bleeding PV with anemia and infection were common outcomes. Large prospective studies are required to assess the magnitude of the problem.
Obstetric outcome in women with threatened miscarriage in the first trimester
Obstetrics and gynecology, 2006
To assess pregnancy outcomes in women with threatened miscarriage in the first trimester. This was a retrospective cohort study based on data extracted from the Aberdeen Maternity and Neonatal Databank. Cases included all primigravid women with first-trimester vaginal bleeding who delivered after 24 weeks of gestation between 1976 and 2004. The control group comprised all other women who had first pregnancies during the same period. Data were analyzed by univariate and multivariate statistical methods. Compared with the control group (n = 31,633), women with threatened miscarriage (n = 7,627) were more likely to have antepartum hemorrhage of unknown origin (odds ratio [OR] 1.83, 95% confidence interval [CI] 1.73-2.01). Elective cesarean (OR 1.30, 95% CI 1.14-1.48) and manual removal of placenta (OR 1.40, 95% CI 1.21-1.62) were performed more frequently in these women, who also had a higher risk of preterm delivery (OR 1.56, 95% CI 1.43-1.71) and malpresentation (OR 1.26, 95% CI 1.13...
Journal of SAFOG, 2018
Aims and objectives: The objectives are to study the effect of vaginal bleeding during first trimester of an intrauterine pregnancy on maternal and perinatal outcomes. Materials and methods: A prospective cohort study was conducted over a duration of 2 years of 430 pregnant women. Data of 210 and 176 women in the study and control group were studied respectively. Study group comprised of women with first-trimester vaginal bleeding and control group comprised of women with no vaginal bleeding, after ultrasonography (USG) confirmation of intrauterine pregnancy done routinely in all women. Maternal and perinatal outcomes were studied in both groups. Results: The two groups were matched in terms of age, parity, socioeconomic status, and body mass index (BMI), and no statistically significant difference was detected in these parameters. A total of 104 women (49.5%) had bleeding during 7 to 8 weeks of gestation. Miscarriage occurred in 96 women (45.7%) with first-trimester vaginal bleeding in study group compared with 20 women (10.2%) among control group; 54.3% women in the study group and 89.8% of women in control group had continuation of pregnancy. The most common type of miscarriage was missed miscarriage (40; 19%) in the study group. Maternal complications occurred more in the study group (74; 64.9%) as compared with 28 (15.9%) in the control group during the course of pregnancy. The incidence of preterm deliveries was higher in the study group (17.5%) than in the control group (2.3%). Most of the women in both the groups delivered by vaginal route. Overall, neonatal complications were higher in the study group (49.1%). The mean birth weight was significantly lower in the study group as compared with control group. Conclusion: Women with first-trimester vaginal bleeding are at increased risk of adverse pregnancy outcomes, such as spontaneous miscarriage, preterm premature rupture of membranes (PPROM), premature rupture of membranes (PROM), intrauterine growth retardation (IUGR), oligohydramnios, low birth weight (LBW), preterm delivery, and increased perinatal morbidity.
INDIAN JOURNAL OF APPLIED RESEARCH
Aims: To assess the pregnancy outcome in women presenting with rst-trimester bleeding per vaginum and pregnancies which continued beyond 13 weeks of gestation. This was a prospective observational s Materials And Methods: tudy done over one year, at a tertiary care hospital in Mumbai. The case group of 100 women presented with a history of bleeding per vaginum in their rst trimester were matched for age, parity, and gestational age with 100 women in the control group and were followed prospectively till delivery, the early postpartum period, and pregnancy outcomes were recorded. A signicant assoc Results: iation was found between bleeding in the rst trimester and adverse maternal (p-value 0.001) and neonatal outcomes (p-value 0.0001). We c Conclusion: onclude that more careful, prolonged follow-up of women with early pregnancy bleeding is needed as these bleeding episodes may be associated with adverse pregnancy outcomes
Maternal complications in women presenting with first trimester threatened miscarriage
The Professional Medical Journal
Objective: To determine the frequency of miscarriage, hypertensive disorder of pregnancy, placental abruption and preterm birth in women with first trimester threatened miscarriage. Study Design: Cross-sectional study. Setting: Department of Obstetric & Gynaecology, Sir Syed Hospital and Pakistan Naval Ship Shifa Hospital (Karachi). Period: April, 2021 to March, 2022. Material & Methods: Ninety two women 18-40 year old, diagnosed as threatened miscarriage at ≤ 13 weeks based on history, examination and ultrasound were included in the study after informed consent and followed till delivery. Women with genital infection, other form of miscarriage and multiple pregnancy were excluded. Data recorded from hospital documents. Maternal age, parity and Gestational age assessed. Miscarriage, hypertensive disorder of pregnancy, placental abruption, preterm birth and PPROM expressed as frequency and percentages. Logistic regression analysis performed. Chi square test (x2) used and P-value ≤ 0....
Maternal and Perinatal Outcomes in Pregnant Women with First Trimester Vaginal Bleeding
Journal of Family & Reproductive Health, 2013
Objective To study the pregnancy outcomes in first trimester vaginal bleeding. Materials and methods This cross sectional study was done on 60 pregnant women with first trimester vaginal bleeding referring to university hospitals affiliated to Islamic Azad University, Tehran, Iran. All women were evaluated for the outcomes including abortion, preterm rapture of membranes, preterm labor, second and third trimester vaginal bleeding, low birth weight and intra uterine growth retardation and the mode of delivery. Data were analyzed using SPSS- 11. Results Placenta accreta, second trimester bleeding and preterm labor were significantly more prevalent in pregnant women with first trimester bleeding (P ≤ 0.05). Conclusion According to results of present study vaginal bleeding in first trimester of pregnancy may predict further maternal and fetal complications. We recommend training pregnant women regarding those complications and their prevention.
Study of Perinataloutcome in Patients Presenting with First Trimester Bleeding
Indian Journal of Scientific Research, 2020
Fist trimester is very crucial period of pregnancy having high risks of pregnancy losses. The occurrence of first trimester bleeding is approximately 25% of all pregnancies. Vaginal bleeding in first trimester is a common complaint. Among these 200 patients, 19% patients aborted. Ectopic and molar pregnancy was seen in 5% and 1.5% patients respectively. Healthy fetus was present in 74.5% cases. Among abortion, missed abortion was seen in 9%, inevitable abortion in 2%, incomplete abortion in 7.5%, and complete abortion occurred in 0.5% cases. Fetal outcome included LBW (28.19%), preterm delivery (21.48%), IUGR (13.42%), fetal distress (11.41%), MSAF (7.38%), malpresentation (2.01%), congenital anomaly (1.34%), IUD and still birth (0.67% each).Neonatal outcome included NICU admission (12.08%), birth asphyxia (5.36%), RDS (4.03%), neonatal sepsis and neonatal jaundice (1.34% each). We concluded that patients with first trimester bleeding are at increased risk for spontaneous pregnancy loss and adverse fetal outcomes like preterm, intrauterine growth restriction, low birth weight, fetal distress, NICU admission and rarely congenital malformation where as there was no significant increase in perinatal mortality. So by knowing the etiology and fetal outcome of first trimester vaginal bleeding, we can predict the complications which will occur in later pregnancy and manage it properly.
Evidence Based Women's Health Journal, 2020
Background: First trimester surgical abortion is a common obstetric procedure with some known complications. Objective: The aim of this study was to examine the incidence of major complications of first trimester surgical abortion in Ain-Shams Maternity Hospital. Patients and Methods: Retrospective record-based case series in which records of patients who underwent first trimester surgical abortion in the period from January 1 st , 2016 till December 31 st , 2017 were examined. Results: A total of 1003 patients underwent first trimester surgical abortion. The overall major complication rate was 18.2%. There was a higher incidence of one or major complications in patients with previous abortions (P-value <0.002), valve replacement (P-value 0.001), missed and septic abortions, those requiring cervical dilatation, less hemoglobin, higher total leucocytic count, higher PTT. Conclusion: First trimester surgical abortion is a relatively safe procedure with hemorrhage being the most common complication.