Threatened abortion in a tertiary hospital in Nigeria: A 5-year experience

Abstract

Background: Threatened abortion usually precedes early pregnancy loss. Affected pregnancy may progress or result in eventual miscarriage. Understanding the risk factors and their management will continue to improve its outcome. Materials and Methods: Records of patients managed for threatened abortion at the OAUTHC, Ile-Ife over a period of 5 years from January 2009 to December 2013 were retrieved. Information about the sociodemographic characteristics, clinical presentation and outcome were collected and analysed using IBM, Armonk, NY, USA-SPSS version 20. Results: One hundred and eight records out of 118 patients admitted for threatened abortion over the period under review were retrieved. There were 2060 gynaecological ward admissions over the period. Threatened abortion accounted for 5.7% of all gynaecological ward admissions. The mean age of women admitted was 29.53 ± 4.47 years and majority (68.5%) had tertiary education. Seventy-five per cent were booked for antenatal care, 53.7% were nulliparous and 42.6% had previous first or second-trimester miscarriage(s). Sixty-two per cent were in the first trimester and the mean gestational age was 12.55 weeks ± 4.78. Malaria fever was the single most common risk factor (47.2%), urinary tract infection and other risk factors were identified in 28.7% and 24.1% had no identifiable risk factor. Half of the patients carried their pregnancy to term, whereas 25.9% had a complete miscarriage and the rest were lost to follow-up. Among those who proceeded to term, 74.1% were booked and 42% were unbooked patients (P value of 0.027). Conclusion: Threatened abortion remains a common complication in early pregnancy. It halves the chances of pregnancy continuation to term. In our environment, malaria fever was the most common risk factor and booking for antenatal care conferred better pregnancy outcome.