Risk and Prediction of Preterm Delivery in Pregnancies Complicated by Antepartum Hemorrhage of Unknown Origin before 34 Weeks

Abstract

Objective: To assess the timing and risk factors of preterm delivery in pregnancies complicated by antepartum hemorrhage of unknown origin (APHUO) before 34 weeks of gestation, and to formulate a clinical management protocol. Methods: A retrospective study involving singleton pregnancies with APHUO occurring before the 34th week of gestation was performed over a 4-year period at a university teaching hospital. Results: Seventy-five cases were identified. Fifty-nine (78.7%) did not have any associated uterine contractions, 74.7 and 90.7% of the cases were classified as having mild bleeding according to history and physical examination, respectively. The number of cases delivering before 37 weeks of gestation and before 34 weeks were 28 (37.3%) and 22 (29.3%), respectively. Eighteen cases (24%) delivered within the first week of APHUO, and 4 (5.3%) within the first day. The number of cases delivering within the first week was significantly higher when there were uterine contractions (62.5 vs. 13.6%, p < 0.001). The severity of bleeding was not shown to be related to the time of delivery. Conclusion: APHUO that occurs before 34 weeks is associated with a high risk of preterm delivery before 34 weeks (29.3%). The chance of delivery within the first week is 62.5% when there are coexisting uterine contractions. Even if contractions are absent, the risk is still high (13.6%) and persists beyond the first week. We suggest that this group of patients should be managed with a course of steroid injection and hospitalization for 4 days.

Demographic and perinatal factors for behavioral problems among children aged 4–9 in Taiwan

“…29 In addition, the present findings and several lines of data support an association of low birthweight with inattention/hyperactivity in childhood. 6 Moreover, the findings of the impact of postnatal resuscitation and incubation on attention problems and social problems suggest a possible consequence of neurodevelopmental disability after neonatal resuscitation.…”

The Relation Between Vaginal Bleeding During Pregnancy and Preterm Birth in Patients Admitted to Martyrs Hospital in Persian Gulf

“…For women with first trimester bleeding or second trimester bleeding, early foetus loss is significantly reduced by increasing the interval between pregnancies (18). Leung et al showed that unexplained bleeding before birth (before 34 weeks of gestation) is associated with high risks of preterm delivery (29.3%) (19). In our study, the spotting and bleeding increased the risk of preterm birth, which is consistent with the study by Weiss et al (20).…”

Clinical Risk Factors for Preterm Birth

“…Antepartum haemorrhage of unknown origin remains the most common cause of bleeding in pregnancy, accounting for more than 50% of all cause of antepartum haemorrhage (Chan & To, 1999). A retrospective analysis into the timing of preterm birth and antepartum haemorrhage showed that the risk of preterm delivery, although higher with associated uterine contractions, was still significant even without contractions: 62.5% versus 13.6% (Leung, et al, 2001). …”