A Prospective Observational Study on Pregnancy Outcome in Women with Threatened Miscarriage in a Tertiary Care Centre

Abstract

BACKGROUND Vaginal bleeding is prevalent in the first trimester of pregnancy and has been linked to poor pregnancy outcomes. The most common issue in the first trimester of pregnancy is threatened miscarriage. We wanted to find the pregnancy outcome and complications of threatened miscarriage. METHODS It is a prospective study conducted on 233 pregnant women with threatened miscarriage at Government T. D. Medical College, Alappuzha. The pregnancy outcomes and complications of threatened miscarriage such as complete miscarriage, preterm labour, preterm prelabour rupture of membrane (PPRO), preeclampsia, placental abruption, placenta previa and intrauterine foetal growth restriction (FGR), mode of delivery, low APGAR score and other foetal complications were noted. Analysis of the data was done using SPSS version 13. RESULTS In 233 cases there were 41 (17.6%) first trimester miscarriage, 9 (3.9%) second trimester miscarriage and 183 (78.5%) pregnancies proceeded to the period of viability. Preterm births were 60 (32.8%) this includes preterm premature rupture of membranes 28 (15.3%), and term deliveries were 123 (67.2%). Out of all women 67 (36.6%) underwent Caesarean section, rest delivered vaginally. Other outcomes were foetal growth restriction 32 (17.5%), gestational hypertension (GHTN) 26 (14.2%), preeclampsia 14 (7.7%), postpartum haemorrhage (PPH) 10 (5.5%), manual removal of placenta (MROP) 2 (1.1%), abruption 5 (2.7%), and placenta previa 8 (4.4%). The perinatal mortality was 1.3% due to birth asphyxia and meconium aspiration syndrome. The study showed that 17.6% ended up in first trimester miscarriage, 3.9% ended up in second trimester miscarriage, and 78.5% proceeded to period of viability, out of whom 32.8% ended up in preterm labour, 67.2% continued till full term labour. CONCLUSIONS Our study has concluded that spotting or light vaginal bleeding without abdominal pain does not increase the risk of miscarriage. According to the findings of our study threatened miscarriage has several adverse maternal and foetal outcomes, which has to be explained to the mother and ensure proper follow up. KEY WORDS Threatened Miscarriage, Pregnancy, Outcome.