A retrospective population-based study of primigravid women on the potential effect of threatened miscarriage on obstetric outcome

Mulik, V.; Bethel, Jackie; Bhal, Kiron

doi:10.1080/01443610410001660724

Cited by 47 publications

(46 citation statements)

References 4 publications

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“…A study done by Mulik et al revealed incidence to be 21.1% which could be due to large sample size taken for the study and use of instrument for the delivery of a distressed fetus. 28 Results from these studies & our study confirm findings from other authors, that threatened abortion is associated with an increased risk of certain pregnancy-related complications, namely abortion, placental abruption, preterm labour, delivery of low birth weight infants and PPROM. 8,30 Generally, high incidence of abortion and adverse pregnancy outcomes in threatened miscarriage indicate the necessity of proper programming in care and also educating high risk women.…”

Section: Instrumental Deliverysupporting

confidence: 91%

See 1 more Smart Citation

Maternal and perinatal outcome in women with threatened abortion in first trimester

Sarmalkar

Singh

Nayak

2016

Int J Reprod Contracept Obstet Gynecol

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Section: Instrumental Deliverysupporting

confidence: 91%

“…30 Mulik et al found a significantly higher risk of placenta praevia at 37 weeks in women who experienced a first-trimester vaginal bleed. 28 …”

Section: Placenta Praeviamentioning

confidence: 99%

Maternal and perinatal outcome in women with threatened abortion in first trimester

Sarmalkar

Singh

Nayak

2016

Int J Reprod Contracept Obstet Gynecol

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“…In sensitivity analysis the exclusion of any one study did not cause the pooled OR to become non-significant, nor increase to more than 2.0. There were no meaningful differences when two studies that only enrolled primigravidas [12–13] were excluded (pooled OR=1.77, I 2 =50.3%), as well as after the exclusion of five studies which only included subjects who had achieved at least 28 weeks gestational age[6–9] (pooled OR=1.81, I 2 =53.8%). Of note, 9 studies did not provide a specific lower gestational age cut-off, and cut-offs for the other studies ranged from 20–25.…”

Section: Resultsmentioning

confidence: 99%

Vaginal bleeding in early pregnancy and preterm birth: systemic review and analysis of heterogeneity

Hackney

Glantz

2010

The Journal of Maternal-Fetal & Neonatal Medicine

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Objective To systemically review published studies of vaginal bleeding and the risk of preterm birth (PTB) and explore sources of heterogeneity between them. Methods The literature was searched for peer-reviewed articles from 1980–2009 in which the primary analysis was the risk of PTB among low risk subjects with and without bleeding. Heterogeneity was assessed through I2 statistics and sources of heterogeneity were explored through subgroup analyses and meta-regression. Results 218 studies were initially identified, 64 reviewed and 23 included. The pooled Odds Ratio for PTB was 1.74, though significant heterogeneity was present (I2=49.7%). Meta-regression demonstrated a significant association between a study’s incidence of bleeding and quality assessment and subsequent odds ratio, such that studies with a lower quality assessment or lower incidence of bleeding demonstrated an increased odds of preterm birth. Conclusions Bleeding in early pregnancy is associated with an increased risk of PTB, however excessive heterogeneity exists among published studies. The heterogeneity arises in part from differences in the reported incidence of bleeding within study populations. Presumably studies that identify bleeding in a larger percentage of subjects consequently dilute the magnitude of the risk.

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“…In addition, collection of outcome data may be subject to inaccuracies with one study relying solely on telephone interviews to obtain final outcomes 13 . A further concern is the lack of clarity regarding the definition of 'threatened miscarriage' and the characterization of symptoms 6 . Few studies quantified symptoms of pelvic pain and vaginal bleeding 10,[13][14][15] , or used validated symptom-scoring questionnaires 10,[13][14][15][16] .…”

Section: Introductionmentioning

confidence: 99%

Early‐pregnancy events and subsequent antenatal, delivery and neonatal outcomes: prospective cohort study

Al‐Memar

Vaulet

Fourie

et al. 2019

Ultrasound in Obstet & Gyne

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Objective To assess prospectively the association between pelvic pain, vaginal bleeding, and nausea and vomiting occurring in the first trimester of pregnancy and the incidence of later adverse pregnancy outcomes. Methods This was a prospective observational cohort study of consecutive women with confirmed intrauterine singleton pregnancy between 5 and 14 weeks' gestation recruited at Queen Charlotte's & Chelsea Hospital, London, UK, from March 2014 to March 2016. Serial ultrasound scans were performed in the first trimester. Participants completed validated symptom scores for vaginal bleeding, pelvic pain, and nausea and vomiting. The key symptom of interest was any pelvic pain and/or vaginal bleeding during the first trimester. Pregnancies were followed up until the final outcome was known. Antenatal, delivery and neonatal outcomes were obtained from hospital records. Logistic regression analysis was used to assess the association between first‐trimester symptoms and pregnancy complications by calculating adjusted odds ratios (aOR) with correction for maternal age. Results Of 1003 women recruited, 847 pregnancies were included in the final analysis following exclusion of cases due to first‐trimester miscarriage (n = 99), termination of pregnancy (n = 20), loss to follow‐up (n = 32) or withdrawal from the study (n = 5). Adverse antenatal complications were observed in 166/645 (26%) women with pelvic pain and/or vaginal bleeding in the first trimester (aOR = 1.79; 95% CI, 1.17–2.76) and in 30/181 (17%) women with no symptoms. Neonatal complications were observed in 66/634 (10%) women with and 11/176 (6%) without pelvic pain and/or vaginal bleeding (aOR = 1.73; 95% CI, 0.89–3.36). Delivery complications were observed in 402/615 (65%) women with and 110/174 (63%) without pelvic pain and/or vaginal bleeding during the first trimester (aOR = 1.16; 95% CI, 0.81–1.65). For 18 of 20 individual antenatal complications evaluated, incidence was higher among women with pelvic pain and/or vaginal bleeding, despite the overall incidences being low. Nausea and vomiting in pregnancy showed little association with adverse pregnancy outcomes. Conclusions Our study suggests that there is an increased incidence of antenatal complications in women experiencing pelvic pain and/or vaginal bleeding in the first trimester. This should be considered when advising women attending early‐pregnancy units. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.

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A retrospective population-based study of primigravid women on the potential effect of threatened miscarriage on obstetric outcome

Cited by 47 publications

References 4 publications

Maternal and perinatal outcome in women with threatened abortion in first trimester

Maternal and perinatal outcome in women with threatened abortion in first trimester

Vaginal bleeding in early pregnancy and preterm birth: systemic review and analysis of heterogeneity

Early‐pregnancy events and subsequent antenatal, delivery and neonatal outcomes: prospective cohort study

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