Skip to main content
Top
Published in: The Journal of Obstetrics and Gynecology of India 5/2013

01-10-2013 | Original Article

Late Pregnancy Outcomes in Women with Vaginal Bleeding in Their First Trimester

Authors: Maryam Sadat Hosseini, Soghra Yaghoubipour

Published in: The Journal of Obstetrics and Gynecology of India | Issue 5/2013

Login to get access

Abstract

Purpose

First trimester vaginal bleeding (FTVB) does not usually terminate the pregnancy. However, its outcome is a matter of debate. This study sought to assess the outcomes of pregnancies, complicated by FTVB.

Methods

In this cohort study, 236 gravida 1 and 2 FTVB patients with delivery after 28 weeks of gestational age, admitted to Imam Hossein Hospital during 2009–2010, were evaluated. The control group consisted of 944 gravida 1 and 2 women without any history of vaginal bleeding. Late pregnancy outcomes such as gestational hypertension, preeclampsia, placental abruption, preterm delivery, and premature rupture of membranes in the mothers and low birth weight (LBW), intrauterine growth restriction(IUGR), Apgar score at 5 min <7, and NICU admission in the infants were evaluated. Logistic regression was used for estimation of odds ratios (OR) and 95 % confidence interval.

Results

Compared to controls, the FTVB cases had more premature rupture of membranes (OR = 10), gestational hypertension (OR = 5.3), and placental abruption (OR = 4.7), while their infants had higher odds of LBW, IUGR, Apgar score at 5 min <7, and admission to NICU too.
The incidence of premature rupture of membranes was 3.6 % in the controls and 27.1 % in the cases (RR = 10, P < 0.001). The incidence of gestational hypertension and LBW was 1.5 and 7.2 % (P < 0.001) in the controls and 6.6 and 12.3 % (P < 0.001) in the cases. The other outcomes were similar in both groups.

Conclusion

FTVB may play a role in the development of late pregnancy outcomes in mothers and infants. Thus, it is recommended to evaluate some interventions on FTVB cases to prevent complications.
Literature
1.
go back to reference Cunningham FG, Leveno KJ, Bloom SL, et al. Williams obstetrics. 23rd ed. New York: McGraw-Hill; 2009. Cunningham FG, Leveno KJ, Bloom SL, et al. Williams obstetrics. 23rd ed. New York: McGraw-Hill; 2009.
2.
go back to reference James DK, Steer PJ, Weiner CP, et al. High risk pregnancy: management options. 4th ed. St. Louis: Saunders/Elsevier; 2010. James DK, Steer PJ, Weiner CP, et al. High risk pregnancy: management options. 4th ed. St. Louis: Saunders/Elsevier; 2010.
3.
go back to reference Hossain R, Harris T, Lohsoonthorn V, et al. Risk of preterm delivery in relation to vaginal bleeding in early pregnancy. Eur J Obstet Gynecol Reprod Biol. 2007;135(2):158–63.PubMedCrossRef Hossain R, Harris T, Lohsoonthorn V, et al. Risk of preterm delivery in relation to vaginal bleeding in early pregnancy. Eur J Obstet Gynecol Reprod Biol. 2007;135(2):158–63.PubMedCrossRef
4.
go back to reference Arafa M, Abdel-Fataah M, Zeid HA, et al. Outcomes of pregnancies complicated by early vaginal bleeding. East Mediterr Health J. 2000;6(2–3):457–64.PubMed Arafa M, Abdel-Fataah M, Zeid HA, et al. Outcomes of pregnancies complicated by early vaginal bleeding. East Mediterr Health J. 2000;6(2–3):457–64.PubMed
5.
go back to reference Yang J, Hartmann KE, Savitz DA, et al. Vaginal bleeding during pregnancy and preterm birth. Am J Epidemiol. 2004;160(2):118–25.PubMedCrossRef Yang J, Hartmann KE, Savitz DA, et al. Vaginal bleeding during pregnancy and preterm birth. Am J Epidemiol. 2004;160(2):118–25.PubMedCrossRef
6.
go back to reference Williams MA, Mittendorf R, Lieberman E, et al. Adverse infant outcomes associated with first-trimester vaginal bleeding. Obstet Gynecol. 1991;78(1):14–8.PubMed Williams MA, Mittendorf R, Lieberman E, et al. Adverse infant outcomes associated with first-trimester vaginal bleeding. Obstet Gynecol. 1991;78(1):14–8.PubMed
7.
go back to reference Wijesiriwardana A, Bhattacharya S, Shetty A, et al. Obstetric outcome in women with threatened miscarriage in the first trimester. Obstet Gynecol. 2006;107(3):557–62.PubMedCrossRef Wijesiriwardana A, Bhattacharya S, Shetty A, et al. Obstetric outcome in women with threatened miscarriage in the first trimester. Obstet Gynecol. 2006;107(3):557–62.PubMedCrossRef
8.
go back to reference Weiss JL, Malone FD, Vidaver J, et al. Threatened abortion: a risk factor for poor pregnancy outcome, a population-based screening study. Am J Obstet Gynecol. 2004;190(3):745–50.PubMedCrossRef Weiss JL, Malone FD, Vidaver J, et al. Threatened abortion: a risk factor for poor pregnancy outcome, a population-based screening study. Am J Obstet Gynecol. 2004;190(3):745–50.PubMedCrossRef
9.
go back to reference Kurjak A, Schulman H, Zudenigo D, et al. Subchorionic hematomas in early pregnancy: clinical outcome and blood flow patterns. J Matern Fetal Med. 1996;5(1):41–4.PubMedCrossRef Kurjak A, Schulman H, Zudenigo D, et al. Subchorionic hematomas in early pregnancy: clinical outcome and blood flow patterns. J Matern Fetal Med. 1996;5(1):41–4.PubMedCrossRef
10.
go back to reference Ananth CV, Oyelese Y, Prasad V, et al. Evidence of placental abruption as a chronic process: associations with vaginal bleeding early in pregnancy and placental lesions. Eur J Obstet Gynecol Reprod Biol. 2006;128(1–2):15–21.PubMedCrossRef Ananth CV, Oyelese Y, Prasad V, et al. Evidence of placental abruption as a chronic process: associations with vaginal bleeding early in pregnancy and placental lesions. Eur J Obstet Gynecol Reprod Biol. 2006;128(1–2):15–21.PubMedCrossRef
11.
go back to reference Johns J, Jauniaux E. Threatened miscarriage as a predictor of obstetric outcome. Obstet Gynecol. 2006;107(4):845–50.PubMedCrossRef Johns J, Jauniaux E. Threatened miscarriage as a predictor of obstetric outcome. Obstet Gynecol. 2006;107(4):845–50.PubMedCrossRef
12.
go back to reference Dongol A, Mool S, Tiwari P. Outcome of pregnancy complicated by threatened abortion. Kathmandu Univ Med J. 2011;9(33):41–4. Dongol A, Mool S, Tiwari P. Outcome of pregnancy complicated by threatened abortion. Kathmandu Univ Med J. 2011;9(33):41–4.
Metadata
Title
Late Pregnancy Outcomes in Women with Vaginal Bleeding in Their First Trimester
Authors
Maryam Sadat Hosseini
Soghra Yaghoubipour
Publication date
01-10-2013
Publisher
Springer India
Published in
The Journal of Obstetrics and Gynecology of India / Issue 5/2013
Print ISSN: 0971-9202
Electronic ISSN: 0975-6434
DOI
https://doi.org/10.1007/s13224-013-0389-z

Other articles of this Issue 5/2013

The Journal of Obstetrics and Gynecology of India 5/2013 Go to the issue