A Study of Maternal and Foetal Outcome in Pregnant Women with History of First Trimester Vaginal Bleeding

Abstract

BACKGROUND
 First trimester vaginal bleeding is an obstetric high-risk, early registration of pregnancy regular antenatal visits and good awareness to the pregnant women and their family members about first trimester vaginal bleeding and the sequelae and the early and remote obstetric and neonatal outcome are needed. The purpose of the study was to observe the effect of first trimester bleeding on maternal & foetal outcomes.
 METHODS
 This study involved all women attending the antenatal clinic at the Department of Obstetrics and Gynaecology with a history of vaginal bleeding in the first trimester or the second trimester or third trimester with prior history of first trimester bleeding at Basaveshwar and Sangameshwar Hospital, attached to MRMC, Kalaburagi. It included a total of 100 singleton pregnant women with vaginal bleeding in the first trimester of pregnancy that was confirmed ultrasonographically. Patients were closely observed and follow-up done 2 weekly up to 36 weeks and weekly after that till delivery. The maternal and foetal outcomes were studied.
 RESULTS
 In the present study, first trimester vaginal bleeding was seen maximum in the age group of 21-25 years about 47 %, seen more in Multigravida 52% than primigravida 44% and 4% in Grandmultipara. Maternal adverse outcomes such as abruption in 8 % of cases, placenta pravia in 15% of cases, placenta accreta in 2 % of cases, preeclampsia in 12 % of cases and PROM in 18 % of cases and preterm labour in 21 % of cases were observed. Among 63 live births, 38 were term babies, 19 were early preterm, 2 were late preterm babies, and 8 were IUGR babies.
 CONCLUSIONS
 In the first trimester, vaginal bleeding is one of the predictors of poor maternal and foetal outcomes later in pregnancy. Both maternal and foetal outcomes are studied considering pregnant women with first-trimester vaginal bleeding as a high-risk category. Proper evaluation of a pregnant woman with first-trimester vaginal bleeding, regular antenatal care, methodical evaluation of bleeding and regular follow-up with the lookout for maternal and foetal complications and awareness to the woman and family members and knowledge about warnings signs in pregnancy to be explained. Proper clinical examination and ultrasonographic evaluation & timely obstetric consultation and interventions play an important role in the management of patients with first-trimester vaginal bleeding.