Effect of Vaginal Bleeding in First Trimester of Pregnancy on Pregnancy Outcomes

Document Type : Original Article (s)

Authors

1 Assistant Professor, Department of Obstetrics and Gynecology, School of Medicine, Najafabad Branch, Islamic Azad University, Isfahan, Iran

2 Department of Community Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

3 Student of Medicine, Islamic Azad University, Najafabad Branch, Isfahan, Iran

Abstract

Background: Vaginal bleeding during pregnancy are one of the important causes of maternal, fetal and neonatal death. Women who remained pregnant after vaginal bleeding, are at risk to complication such intrauterine fetal death (IUFD), intra uterine growth retardation (IUGR), preterm labor, placental abruption, preterm pre-labor rupture of membrane (PROM) and low birth weight.Methods: This study was a prospective case–control study that was done on 120 pregnant, 60 women with first trimester bleeding and 60 control women, in Shariati hospital in Isfahan, Iran. All women were evaluated for pregnancy outcomes including bleeding in second and third trimester, abortion, preterm pre labor rupture of membrane, preterm labor, low birth weight, Intra uterine growth retardation, mode of labor, APGAR coefficient in 5 minute, neonatal intensive care unit (NICU) admission. Data was analyzed by student t-test and χ2.Findings: There were no significant differences between groups in number of previous pregnancies and labors, number of children, history of abortion, premature rupture of membrane (PROM), intrauterine fetal death (IUFD), mod of labor, APGAR coefficient, NICU admission and intra uterine growth retardation (IUGR) (P ≥ 0.05). But there were significant differences between groups in placenta accreta, second trimester bleeding and preterm labor (P ≤ 0.05). Conclusion: According to our results and other studies from other countries, first trimester bleeding could predict maternal and fetal complications. We recommend to train pregnant women about these complications and their prevention.

Keywords

References

  1. Deutchman M, Tubay AT, Turok D. First trimester bleeding. Am Fam Physician 2009; 79(11): 985-94.
  2. Schauberger CW, Mathiason MA, Rooney BL. Ultrasound assessment of first-trimester bleeding. Obstet Gynecol 2005; 105(2): 333-8.
  3. Dogra V, Paspulati RM, Bhatt S. First trimester bleeding evaluation. Ultrasound Q 2005; 21(2): 69-85; quiz 149-50, 153-4.
  4. Hasan R, Baird DD, Herring AH, Olshan AF, Jonsson Funk ML, Hartmann KE, et al. Patterns and predictors of vaginal bleeding in the first trimester of pregnancy. Ann Epidemiol 2010; 20(7): 524-31.
  5. Falco P, Zagonari S, Gabrielli S, Bevini M, Pilu G, Bovicelli L, et al. Sonography of pregnancies with first-trimester bleeding and a small intrauterine gestational sac without a demonstrable embryo. Ultrasound Obstet Gynecol 2003; 21(1): 62-5.
  6. Neiger R, Wise C, Contag SA, Tumber MB, Canick JA. First trimester bleeding and pregnancy outcome in gravidas with normal and low folate levels. Am J Perinatol 1993; 10(6): 460-2.
  7. De Biasio P, Canini S, Crovo A, Prefumo F, Venturini PL. Early vaginal bleeding and first-trimester markers for Down syndrome. Prenat Diagn 2003; 23(6): 470-3.
  8. Laing F, Mendelson E, Böhm-Velez M, Bree R, Finberg H, Fishman EK, et al. First trimester bleeding. American College of Radiology. ACR Appropriateness Criteria. Radiology 2000; 215(Suppl): 879-93.
  9. Thorstensen KA. Midwifery management of first trimester bleeding and early pregnancy loss. J Midwifery Womens Health 2000; 45(6): 481-97.
  10. Madan I, Romero R, Kusanovic JP, Mittal P, Chaiworapongsa T, Dong Z, et al. The frequency and clinical significance of intra-amniotic infection and/or inflammation in women with placenta previa and vaginal bleeding: an unexpected observation. J Perinat Med 2010; 38(3): 275-9.
  11. De Sutter P, Bontinck J, Schutysers V, Van der Elst J, Gerris J, Dhont M, et al. First-trimester bleeding and pregnancy outcome in singletons after assisted reproduction. Hum Reprod 2006; 21(7): 1907-11.
  12. Paspulati RM, Bhatt S, Nour SG. Sonographic evaluation of first-trimester bleeding. Radiol Clin North Am 2004; 42(2): 297-314.
  13. Saraswat L, Bhattacharya S, Maheshwari A, Bhattacharya S. Maternal and perinatal outcome in women with threatened miscarriage in the first trimester: a systematic review. BJOG 2010; 117(3): 245-57.
  14. Kim YJ, Lee BE, Park HS, Kang JG, Kim JO, Ha EH. Risk factors for preterm birth in Korea: a multicenter prospective study. Gynecol Obstet Invest 2005; 60(4): 206-12.
  15. Siddiqui F, Kean L. Intrauterine fetal death. Obstetrics, Gynaecology and Reproductive Medicine 2009;19(1):1-6.
  16. Gottschalk EM, Siedentopf JP, Schoenborn I, Gartenschlaeger S, Dudenhausen JW, Henrich W, et al. Prenatal sonographic and MRI findings in a pregnancy complicated by uterine sacculation: case report and review of the literature. Ultrasound Obstet Gynecol 2008; 32(4): 582-6.
  17. Williams MA, Mittendorf R, Lieberman E, Monson RR. Adverse infant outcomes associated with first-trimester vaginal bleeding. Obstet Gynecol 1991; 78(1): 14-8.
  18. Weiss JL, Malone FD, Emig D, Ball RH, Nyberg DA, Comstock CH, et al. Obesity, obstetric complications and cesarean delivery rate--a population-based screening study. Am J Obstet Gynecol 2004; 190(4): 1091-7.
  19. Spencer K, Spencer CE, Stamatopoulou A, Staboulidou I, Nicolaides KH. Early vaginal bleeding has no impact on markers used in first trimester aneuploidy screening. Prenat Diagn 2010; 30(6): 547-50.
  20. Lykke JA, Dideriksen KL, Lidegaard O, Langhoff-Roos J. First-trimester vaginal bleeding and complications later in pregnancy. Obstet Gynecol 2010; 115(5): 935-44.
  21. Snell BJ. Assessment and management of bleeding in the first trimester of pregnancy. J Midwifery Womens Health 2009; 54(6): 483-91.
  22. Harlev A, Levy A, Zaulan Y, Koifman A, Mazor M, Wiznitzer A, et al. Idiopathic bleeding during the second half of pregnancy as a risk factor for adverse perinatal outcome. J Matern Fetal Neonatal Med 2008; 21(5): 331-5.
Journal of Isfahan Medical School
Volume 29, Issue 156 - Serial Number 156
July and August 2011
Pages 1462-1468

Files

History

  • Receive Date: 12 April 2011
  • Revise Date: 29 April 2024
  • Accept Date: 06 April 2022

Share

How to cite

Statistics