Vaginal Bleeding in the Last Two Trimesters of Pregnancy a Clinical and Ultrasonic Study

Jouppila, Pentti

doi:10.3109/00016347909154068

Cited by 15 publications

(5 citation statements)

References 7 publications

(3 reference statements)

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“…The risk of PTB observed in our study (RR=3.9 [3.1-4.8] vs. control) is consistent with our previous findings (34.5% preterm birth) [5], with data previously reported by Ramaecker et al [8] (RR=1.56, 95% CI [1.14-2.14]) and with the meta-analysis of Ananth et al [11], which examined the outcomes of pregnancies complicated by bleeding (RR for PTB=2.2, 95% CI [2.1-2.4]). The recurrence of bleeding was associated with an increased rate of PTB in our series in agreement with the results reported by Yang and Jouppila (RR=1.7, 95% CI [1.2-2.3]) [6,12].…”

Section: Discussionsupporting

confidence: 92%

Perinatal outcomes of second trimester antenatal genital bleeding

2020

Clinical and Experimental Obstetrics & Gynecology

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Objective: To evaluate the prognosis of singleton pregnancies complicated by genital bleeding during the 2 nd trimester and to identify the factors associated with poor perinatal outcome. Materials and Methods: We conducted a retrospective study (January 2009 to December 2012), which included all women presenting with midtrimester bleeding (15 to 27 weeks of gestation). The cases were compared with women without bleeding, who delivered in our center during the same period. Results: Ninety-seven women were included (0.57% of the overall singleton births). An underlying placental cause was discovered by ultrasound in 56% of the cases (low-lying placenta, partially detached placenta or a combination of both of these pathologies). We report a significantly increased rate of preterm birth (47.4% vs. 12.2%; RR=3.9), perinatal mortality (11.3% vs. 1.3%; RR=8.8), PPROM (16.5% vs. 3.7%; RR=4.5; CI 95% [2.8-7.1]), and cesarean section (42.3% vs. 21%; RR=2; CI 95% [1.6-2.5]) in the bleeding group. The factors associated with preterm birth were recurrent bleeding (OR=4.7), gestational age > 22 WG at the first bleeding (OR=3.7), and low-lying placenta. Conclusion: Despite a low incidence, the occurrence of bleeding in the 2 nd trimester of pregnancy should alert the physician because of increased perinatal morbimortality. These patients may thus require increased monitoring.

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Section: Discussionsupporting

confidence: 92%

Perinatal outcomes of second trimester antenatal genital bleeding

2020

Clinical and Experimental Obstetrics & Gynecology

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“…In contrast, bleeding in the second trimester only, of a single episode, on a single day, and with less total blood loss was not associated with any category of preterm birth. 49 Recurrent bleeding predicted preterm birth more strongly than did single episodes, consistent with previous studies, as stated by Williams et al 50,51 However, a series of studies have demonstrated that APH is an independent factor for adverse neonatal outcomes in very preterm, as well as late preterm neonates. Among these groups APH has been independently associated with increased neonatal mortality and morbidity, particularly severe respiratory disorders, increased admission rate to NICU and increased hospital stay.…”

Section: Discussionsupporting

confidence: 83%

Untitled

2020

MIJOBG

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Aims and Objectives: 1 To study perinatal outcome in early pregnancy hemorrhage.2)To study perinatal outcome in late pregnancy hemorrhage. Materials and Methods: 1. This is observational prospective study performed within span of 1 year (August 2014 to July 2015) in the Department of Obstetrics and Gynaecology in ACPM Medical college, Dhule. 2 Total number of 200 women with bleeding per vaginal during pregnancy were enrolled in the study. The patients who presented with vaginal bleeding were divided into: 1 Early pregnancy bleeding < 20 weeks, 2. Late pregnancy bleeding > 20 weeks Since the demographic profile, etiology, risk factors involved, maternal and perinatal morbidities and mortalities associated with early and late pregnancy group are drastically different, so the cases in this study are divided into two groups -EARLY (<20 weeks) and LATE (>20 weeks). Results: In this study, 66% patients presented with early pregnancy bleeding and 34% with late pregnancy bleeding. Perinatal outcome in Early pregnancy bleeding:-30% spontaneous abortion, 7.6% preterm delivery, 4.5% IUGR. Perinatal outcome in Late pregnancy bleeding:-3% stillbirth, 14.7% IUGR, 5.9% IUD, 58.8% preterm birth, 2.9% early and late neonatal deaths. Conclusion: Vaginal bleeding at any stage of pregnancy is an alarming event and can be potentially life-threatening to mother and fetus. Obstetrician should ensure that patient delivers in a well equipped centre with NICU facilities and expertization of neonatologist.

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“…Uterine bleeding during the second and third trimesters is a relatively common complication of pregnancy, occurring in approximately 4% to 5% of antenatal patients and, from whatever cause, is associated with an increased incidence of premature births and perinatal deaths 1 . The causes of uterine bleeding in the second half of pregnancy include implantation of the placenta over or near the cervix (placenta praevia), premature separation of a normally implanted placenta (placental abruption), and the remainder in which the cause of the bleeding remains unknown (uterine bleeding of unknown aetiology).…”

Section: Introductionmentioning

confidence: 99%

Influence of hypertensive disorders and cigarette smoking on placental abruption and uterine bleeding during pregnancy

Ananth

Savitz

Bowes

et al. 1997

BJOG

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Objective To assess the influence of hypertensive disorders in pregnancy on the subsequent risk of placental abruption and uterine bleeding of unknown aetiology, and to examine the combined effects of hypertensive disorders and cigarette smoking during pregnancy on the risk of uteroplacental bleeding disorders.Design Retrospective cohort study.Setting Data for this study were derived from the Nova Scotia Atlee Perinatal database, Canada, comprising of women who were delivered in the province between 1980 and 1993.Population 120,666 pregnancies resulting in singleton births, of which 13,360 pregnancies were complicated by pre-eclampsia andor chronic hypertension. Main outcome measuresRisks and relative risks of placental abruption and uterine bleeding of unknown aetiology in pregnancies complicated by chronic hypertension, mild and severe preeclampsia, and chronic hypertension with superimposed pre-eclampsia, each compared with normotensive patients. Adjusted relative risks were obtained through the fit of multivariable logistic regression models based on the method of generalised estimating equations. ResultsChronically hypertensive women had no increased risk of abruption (RR 1-4; 95% CI 0.5-3.6), while women whose pregnancies were complicated by severe pre-eclampsia (RR 3.8; 95% CI 2.1-6*9), and chronic hypertension with superimposed pre-eclampsia (RR 2-8; 95% CI 1-2-6.3) showed strong associations with placental abruption. However, none of the hypertensive disorders were associated with uterine bleeding of unknown aetiology. The association between placental abruption and hypertensive disorders varied by parity. Parous women with chronic hypertension and superimposed pre-eclampsia were at greater risk of placental abruption (aRR 3.8; 95% CI 1-9-7-8) than nulliparous women with chronic hypertension and superimposed pre-eclampsia (aRR 1.6; 95% CI 0.5-4.9). The joint effects of smoking and hypertension had a greater effect on the risk of placental abruption than would have been expected based on their individual effects. ConclusionsThe pattern of association between placental abruption and hypertension varied in relation to the specific type of hypertensive disorder. However, uterine bleeding of unknown aetiology was not associated with hypertension. Findings from this study suggest that placental abruption and uterine bleeding of unknown origin are aetiologically distinct obstetric complications with respect to hypertensive disorders during pregnancy,

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Vaginal Bleeding in the Last Two Trimesters of Pregnancy a Clinical and Ultrasonic Study

Cited by 15 publications

References 7 publications

Perinatal outcomes of second trimester antenatal genital bleeding

Perinatal outcomes of second trimester antenatal genital bleeding

Untitled

Influence of hypertensive disorders and cigarette smoking on placental abruption and uterine bleeding during pregnancy

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