Publication:

Pregnancy outcome in women with first trimester vaginal bleeding: a prospective cohort study

Background 15 –25% of all pregnant women experience first trimester vaginal bleeding, a major obstetric hazard to the growing embryo. This study aimed to study the maternal and fetal outcome in women with first trimester vaginal bleeding.

Methods This was a prospective study conducted in Department of Obstetrics and Gynecology, Credence Hospital, Thiruvananthapuram, Kerala over a period of 18 months. All women with singleton pregnancy with first trimester vaginal bleeding, were included and compared with group without history of first trimester vaginal bleeding during the same period. A detailed history was taken, the characteristics of all the patients and outcome of mother and baby were noted and data was collected through self-administered pretested structured questionnaire.

Results It showed that study variables such as age, socio-economic status, BMI, obstetric score, chronic hypertension, hypothyroidism were found to have no statistically significant association with vaginal bleeding. Mode of conception, H/O bleeding in previous pregnancies, pre gestational diabetes were statistically significant. Variables such as GDM, PROM, FGR, preterm delivery, mode of delivery, gestational age were examined as statistically significant risk factors of first trimester vaginal bleeding. Incidence of miscarriage, gestational diabetes, PPROM, FGR, Preterm delivery, Low birth weight, Low APGAR score and NICU admissions were higher in subjects with first trimester bleeding when compared to comparative group.

Conclusions Such high-risk cases need utmost care and well-equipped medical center so that risk can be reduced or prevented.