First-Trimester Vaginal Bleeding and Adverse Obstetric Outcomes in a Semi-urban Population of India: A Prospective Observational Study.

Abstract

Background This study aimed to investigate the obstetric outcomes in antenatal women with first-trimester vaginal bleeding. Methodology This single-centered, prospective, observational study was conducted in a tertiary healthcare institution. Antenatal women with first-trimester vaginal bleeding who visited the hospital were screened for eligibility and included in the study. They were followed up until the termination of pregnancy or delivery based on the etiology of vaginal bleeding. Various fetomaternal outcomes such as pregnancy outcomes, obstetric complications, mode of delivery, and neonatal outcomes were analyzed. Results This study included 120 antenatal women who experienced first-trimester vaginal bleeding during the study period. Vaginal bleeding was more prevalent in the age group of 25-34 years and primigravidas. Out of 120 women, 14 (11.6%) either aborted or the pregnancy was terminated as a result of a nonviable gestation, and 106 (88.4%) delivered after the period of viability. Out of 106 women, 56 (52.8%) had full-term pregnancies without any obstetric complications. We analyzed the obstetric complications developed in all the study participants and found that 23 (21.7%) had preterm labor, 12 (11.3%) had placental abruption, 6 (5.7%) had premature rupture of membrane, 4 (3.9%) had anemia, and 2 (1.9%) developed hypertensive disorder of pregnancy. Of all deliveries, 54 (50.9%) delivered vaginally and 52 (49.1%) had cesarean delivery. There were no major adverse neonatal outcomes in terms of birthweight, APGAR score at one minute, and APGAR score at five minutes. Conclusions A large proportion of antenatal women with first-trimester vaginal bleeding can have favorable perinatal outcomes. However, as a few may develop obstetric complications, regular follow-up of such cases is mandated to prevent adverse outcomes.