Predicting adverse maternal and perinatal outcome after threatened miscarriage

Abstract

Objectives: Threatened miscarriage is the most common complication of pregnancy, occurring in 20%-25% of ongoing pregnancies. The purpose is to study maternal and perinatal outcome in women with threatened miscarriage. Methods: A prospective study was conducted over a period of 20 months in the Department of Obstetrics and Gynaecology, Pannadhay Mahila Chikitsalaya, a tertiary care center in Udaipur, India. It included a cohort of pregnant patients with a history of threatened miscarriage during the first twenty weeks of pregnancy. They were registered, followed up prospectively at antenatal clinics and delivered in the same hospital. For the purpose of comparison, another group of booked patients (controls) without a history of threatened miscarriage were recruited, similarly scanned and followed throughout pregnancy and labour. All women were matched for age, parity, social class, BMI and gestational age at booking. Discrete variables were taken as counts (or frequencies) and were evaluated by Chi-square test. Continuous variables with normal distribution were presented as mean ± standard deviation (SD) and were compared by unpaired Student's t test. Data were fed into a Microsoft Excel worksheet and were analyzed by using the SPSS ver.17 (SPSS Inc., Chicago, IL, USA). p-value > 0.05 was considered statistically significant. Results: Out of 62 cases, 13 (21%) patients spontaneously aborted after diagnosis of threatened miscarriage. Women with threatened miscarriage had a significantly higher incidence of low lying placenta (p = 0.02) when compared with those without firsttrimester bleeding. They were more likely to experience PROM (p = 0.02), preterm delivery (p = 0.02) and to have babies with low Birthweight (p = 0.03). Conclusion: Pregnancies complicated by threatened miscarriage are at a higher risk for obstetric complications.

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

“…A previous study done by Agarwal et al found an incidence of 21% in 62 patients with a history of threatened abortion in first twenty weeks of pregnancy. 9 Another study by Ahmed et al showed the incidence of abortion in 85 patients with bleeding in first twenty weeks of pregnancy to be 17%. 10 The lower rate of abortion in our study could be attributed to the fact that we have included only first trimester threatened abortion.…”

First trimester bleeding and pregnancy outcome

“…later in pregnancy causing adverse outcomes such as increased risk of pre-eclamptic toxemias, preterm delivery, prelabour rupture of membranes(PROM), and IUGR. 3 The purpose of this study was to investigate the effect of first trimester vaginal bleeding on maternal and perinatal outcomes.…”

Antimicrobial Prophylaxis for Women with First Trimester Vaginal Bleeding Could Reduce the Rate of Miscarriage

“…The incidence of fetal loss reported varies among studies due to the fact that many studies are retrospective, of small sample size or relied on patients recall recruiting later in pregnancy. Agrawal S and colleagues (2014) in a small prospective case control study found the overall spontaneous miscarriage rate for patients after diagnosis of a viable pregnancy by ultrasound as 21% for cases versus 5.45% for control group [12].…”