Abstract
Background: Threatened miscarriage is defined as any bleeding in the first half of pregnancy and is seen in about 20–25% of pregnancies therefore is a fairly common complication during pregnancy. Most of the time bleeding is a small amount, but sometimes it may be more serious and severe. About 50% of cases of threatened miscarriage terminate in complete miscarriage and loss of pregnancy. If pregnancy continues, the sub optimal events have been reported more; like preterm delivery and Preeclampsia. The aim of the study was to evaluate the pregnancy outcome in pregnancies with threatened abortion (miscarriage).
Methods: This prospective cohort study was conducted at the Department of Obstetrics and Gynecology, Al-Azhar University Hospitals on 70 pregnant women; 35 women (case group) had a history of vaginal bleeding during the first half of pregnancy and the other 35 women (control group) do not had this history. Each case in the study was subjected to the following: Detailed obstetric and gynaecological history. Clinical examination. Gestational age according to the last menstrual period and ultrasound findings. The following pregnancy outcomes between the two groups were compared: abortion, preterm delivery, IUGR, IUFD, PPROM, LBW, preeclampsia, type of delivery.
Results: There was statistically significant difference between Cases and Control regarding (abortion, preterm labour and PPROM). There were no statistically significant difference between Cases and Control regarding (age, preeclampsia development, IUGR, IUFD, LBW, placenta previa, low lying placenta, NICU admission and type of delivery).
Conclusion: Pregnant women with threatened abortion are at increased risk for spontaneous loss and adverse pregnancy outcomes. Current study reports that patients with history of vaginal bleeding during the first half of pregnancy are at a risk for spontaneous pregnancy loss and adverse pregnancy outcomes. For patients who reported vaginal bleeding during the first trimester, high risks of abortion, LBW, preterm delivery, PPROM, and low lying placenta were observed. These associations are clinically significant since they denote increased morbidity and mortality.
Keywords: Threatened miscarriage –pregnancy- outcome.
References
- Agrawal S, Khoiwal, S., Jayant, K., Agarwal, R. Predicting Adverse Maternal And Perinatal Outcome After Threatened Miscarriage. Open Journal Of Obstetrics And Gynecology. 2014;4(1):1-7.
- Ahmed SR, El-Sammani Mel K, Al-Sheeha MA, Aitallah AS, Jabin Khan F, Pregnancy Outcome In Women With Threatened Miscarriage: A Year Study. Materia Socio-Medica. 2012;24(1):26-8.
- Arafa M, Abdel-Fataah M, Zeid HA, el-Khouly A. (2000): Outcomes of pregnancies complicated by early vaginal bleeding. East Mediterr Health J;6(2–3):457–64.
- Basama FM, Cros Fill F. (2004): The outcome of pregnancies in 182 women with threatened miscarriage. Arch Gynecol Obstet;270(2):86–90.
- Ben-Haroush A, Yogev Y, Mashiach R, Meizner I. (2003): Pregnancy outcome of threatened abortion with subchorionic hematoma: possible benefit of bed-rest? Isr Med Assoc J;5:422–4.
- Cunningham FG, Leveno KJ, Bloom SL, Hauth JC, Gilstrap III LC, Wenstrom KD. (2005):Williams obstetrics. twenty second (22nd) edition. USA: MCGraw-hill, New York;. p. 239–41.
- Dadkhah, F., Kashanian, M., &Eliasi, G. (2010). A comparison between the pregnancy outcome in women both with or without threatened abortion. Early Human Development, 86(3), 193–196. doi:10.1016/j.earlhumdev.2010.02.005
- Das AG, Gopalan S, Dhaliwal LK. (1996): Fetal growth and perinatal outcome of pregnancies continuing after threatened abortion. Aust NZ J Obstet Gynaecol;36(2):135–9.
- Davari-Tanha F, Shariat M, Kaveh M, Ebrahimi M, Jalalvand S. Threatened Abortion: A Risk Factor For Poor Pregnancy Outcome. ActaMedicaIranica. 2008;46(4):314-320.
- De Sutter P, Bontinck J, Schutysers V, Van der Elst J, Gerris J, Dhont M. (2006):Firsttrimester bleeding and pregnancy outcome in singleton after assisted reproduction. Hum Reprod;21(7):1907–11.
- Hossain R, Harris T, Lohsoonthorn V, Williams MA. Risk Of Preterm Delivery In Relation To Vaginal Bleeding In Early Pregnancy. European Journal Of Obstetrics, Gynecology, And Reproductive Biology. 2007;135(2):158-63.
- Makikallio K, Tekay A, Jouppila P. Uteroplacental Hemodynamics During Early Human Pregnancy: A Longitudinal Study. Gynecologic And Obstetric Investigation. 2004;58(1):49-54.
- Mulik V, Bethel J, Bhal K. (2004): A retrospective population-based study of primigravid women on the potential effect of threatened miscarriage on obsteric outcome. J Obstet Gynaecol;24(3):249–53.
- Sarmalkar MS, Singh S, Nayak AH. Maternal and perinatal outcome in women with threatened abortion in first trimester. Int J ReprodContraceptObstetGynecol 2016;5:1438-45.
- Sheiner E, Levy A, Katz M, Mazor M. Pregnancy Outcome Following Recurrent Spontaneous Abortions. European Journal Of Obstetrics &Gynecology And Reproductive Biology.2005;118(1):61-5.
- Verma SK, Premi HK, Gupta TV, Thakur S, Gupta KB, Randhawa L. (1994): Perinatal outcome of pregnancies complicated by threatened abortion. J Indian Med Assoc;92(11):364–5.
- Weiss JL, Malone ED, Vidaver J, Ball RH, Nyberg DA, Comstock CH, et al. (2004): Threatened abortion: a risk factor for poor pregnancy outcome, a population-based screening study. Am J Obstet Gynecol;190(3):745–50.
Corresponding Author
Islam Abdelrazek Mohamed
Phone Number: 01009192420
DOI: https://dx.doi.org/10.18535/jmscr/v7i3.104
