The study of first-trimester vaginal bleeding and its maternal and perinatal outcomes at a tertiary care center in Hyderabad

Abstract

Background: Among all those pregnancies with first-trimester vaginal bleeding, nearly half of them terminate into a pregnancy loss. In case the pregnancy continues, it may result in some complications such as intrauterine growth retardation (IUGR), preterm prelabor rupture of membrane (PPROM), preterm delivery, placental abruption, and preeclampsia. Objective: The objective was to study the pregnancy outcomes in first-trimester vaginal bleeding. Materials and Methods: This retrospective observational study was done on 100 antenatal women who attended our hospital for delivery and had a history of first-trimester vaginal bleeding. All women were evaluated for pregnancy outcomes including pregnancy-induced hypertension, anemia, abruption, preterm labor, premature rupture of membrane (PROM), PPROM, IUGR, and placenta previa and neonatal outcomes in the form of birth weight and APGAR score. Results: Ninety-nine percentage of cases had viable outcome, and only one case had abortion after 20 weeks. Sixteen percentage had fetal growth restriction (IUGR), fifteen percentage had anemia, 14% had preterm labor, 12% had gestational hypertension, 11% had PROMs, 4% had preterm PROMs, and 2% had placental abruption and placenta previa. Among 16 patients who developed IUGR, 31% had abnormal Doppler and 69% had normal Doppler. Sixty percentage of patients delivered after 37 weeks. One case each of postpartum hemorrhage and perinatal death were observed. Conclusions: First-trimester vaginal bleeding is an important factor in predicting late pregnancy maternal and fetal outcomes. These pregnancies should be considered high risk, and antenatal care should be given carefully. Pregnant women need to be trained regarding the associated complications and their timely management.