Publication:

Maternal and fetal outcomes in women with first-trimester threatened abortion: a prospective observational study from a tertiary care centre in North India

Background Threatened abortion- vaginal bleeding before 20 weeks with a closed cervix and a viable intrauterine pregnancy- complicates roughly 15-25% of pregnancies and is associated with later adverse outcomes. Prospective regional data from north India remain limited. We described maternal and fetal outcomes in such women and examined their association with demographic factors.

Methods This prospective observational study was conducted in the department of obstetrics and gynecology at a tertiary centre in Barabanki, Uttar Pradesh, over 18 months. Women aged 18-35 years with a singleton pregnancy and first-trimester vaginal bleeding (<14 weeks) were enrolled consecutively and followed to delivery. Maternal and fetal endpoints were recorded; categorical associations were tested by chi-square (p<0.05).

Results Of 250 women, 41 (16.4%) progressed to abortion and 209 continued to delivery. Pre-eclampsia occurred in 30.4%, eclampsia in 9.6%, placenta previa in 7.6%, abruption in 4.0%, preterm premature rupture of membranes in 17.7% and preterm labour in 22.0%. The caesarean rate was 47.4%. Low birth weight occurred in 52.6%, NICU admission in 13.9% and stillbirth in 10.1%. Good maternal and fetal outcomes were recorded in 69.6% and 75.6%, respectively. Maternal outcome was associated with age (p<0.001), socioeconomic status (p=0.005) and locality (p=0.001); fetal outcome was associated with age (p<0.001), socioeconomic status (p=0.007) and locality (p=0.001).

Conclusions Women with first-trimester threatened abortion carried a substantial burden of maternal and perinatal morbidity, concentrated among older, lower-socioeconomic and rural women. This group warrants intensified antenatal surveillance and early risk stratification.