Severe Vaginal Bleeding Research Articles

A Case Report On: Incomplete Abortion with Chronic Hypertension

Introduction: Abortion is a distressing experience that affects the mother in a variety of ways by influencing on emotional status that can finally result in psychological disorders such as depression [1]. An incomplete abortion occurs when the products of conception are lost in the first 20 weeks of pregnancy. Moderate to severe vaginal bleeding, as well as lower abdomen and/or pelvic pain, are common symptoms of incomplete abortion [2]. Substantial evidence indicates that women with a history of spontaneous abortion have a greater risk of non-communicable diseases, including hypertension, cardiovascular diseases, and type 2 diabetes [3]. In low and middle-income nations, abortion is one of the most common causes of maternal death [4]. In general, incomplete abortions are unavoidable, with chromosomal abnormalities accounting for 50% of all occurrences. Age, maternal disorders (diabetes, hypertension, renal disease, thyroid issue, polycystic ovarian syndrome, lupus, thrombophilia), under or overweight, aberrant uterus, teratogen exposure (drug, alcohol, caffeine, radiation), and infections are all changeable etiologies and risk factors (human immunodeficiency virus, sexually transmitted infections, Listeria monocytogenes) [2].
 Case Presentation: A 30-year-old woman's case study with 15 weeks pregnant admitted in the obstetric and gynecological unit on the date 11 June 2021 with complaints of amenorrhea since 4 months, bleeding per vaginam, passage of clots, blurring of vision, pain in abdomen, breathlessness and her blood pressure was noted as 140/100mm of Hg. Interventions: Generally, the patient with abortion and raised blood pressure is hospitalized and care is provided in the obstetric and gynecological unit or ward. The goals during this phase are saving a life of mother, maintaining and restoring hemodynamic stability and preventing the spread of infection or correcting the complication.
 Outcomes: During the period of five days treatment, the client was having raised blood pressure but significantly the client’s health was improved with further treatment and management .After a hospital stay of five days the markable progress was seen further before returning to the home. Discussion: Although the patient reacted well to treatment, more interventions and health education could be used in the future to help the patient to achieve the better health results.

A rare cause of postpartum vaginal bleeding

BackgroundInvasive mole is a trophoblastic disease (GTD) caused by trophoblast cells invading the myometrium during pregnancy. The GTD range also includes mole hydatidiform, choriocarcinoma, and placental site trophoblastic tumor (PSTT). Invasive moles are most common following molar pregnancies; however, they can even rarely occur after a full-term birth. Despite the fact that pathology is the only way to make a clear diagnosis, clinic and radiologic evaluation can be helpful. We wanted to highlight a rare incidence of invasive mole following a healthy full-term delivery in this case.Case presentationA 28-year-old female patient presented with intermittent prolonged severe vaginal bleeding for 2 weeks after a term healthy vaginal delivery. In workup, beta human chorionic gonadotropin levels (b-hCG) value was 7540 mIU/ml. After suspicion of gestational trophoblastic neoplasm (GTN), the patient was sent to ultrasonography (US) and magnetic resonance imaging (MRI). GTN was confirmed by radiological and clinical findings, and a conclusive diagnosis of an invasive mole was made histopathologically.ConclusionInvasive mole should be considered in the differential diagnosis in patients with postpartum bleeding and a persistently high b-hCG level after a healthy term delivery.

Intranatal (labor & child birth) and postnatal care services – Role of ASHAs

BackgroundMaternal mortality and neonatal mortality are substantial burden in developing countries. Every pregnant woman during all the 3 trimesters, during labor & postpartum period is at the risk of facing sudden, unpredictable complications that could end in death or injury to herself or to her infant. Complications like abortion, preeclampsia, eclampsia, ruptured uterus, puerperal sepsis, postpartum haemorrhage etc. which result in maternal mortality, morbidity and perinatal death are unpredictable. ObjectiveTo assess the knowledge of ASHAs regarding intranatal and postnatal care services. MethodologyA cross sectional study was conducted on ASHAs of 2 PHCs and 1 CHC of Belagavi Rural area. All (100) ASHAs were included in the study. Ethical clearance and Informed consent was obtained. Data regarding the knowledge of ASHAs about their roles and responsibilities towards intranatal and postnatal care services was collected using questionnaire by JHPIEGO. ResultsThe findings of the study revealed that ASHAs had knowledge about high BP 75%, 64%, severe vaginal bleeding 82%, 95%, convulsions (43%) during Labor and Childbirth and during postpartum period respectively. They had very low knowledge regarding - prolonged labor (12%), retained placenta (7%). Early breastfeeding (93%), dry and wrap (100%) and exclusive breastfeeding (80%) were 3 basic cares provided to the baby. There was a significant linear association between knowledge and level of education of ASHAs (p-value - 0.0092). ConclusionKnowledge of ASHAs about intranatal and postnatal care services was poor. Hence need of the hour is to train ASHAs regarding intranatal and postnatal care services.

Coagulopathy State in Pregnant Women with COVID-19 involvement: 2 Case Reports

Pregnant women appear to be more severely affected by COVID-19. Coagulopathy is known as one of the most challenging effects of COVID-19, and the effects of acute airway diseases resulting from the coronavirus on pregnant mothers and their fetuses can be dangerous. Two women who where pregnant suffering from coagulopathy (one of them with disseminated intravascular coagulation (DIC) and the other one with hypercoagulation) and COVID-19 infection are reported in this study. During hospitalization due to severe vaginal bleeding and placental detachment, cesarean section was performed on the first caseand because of acute severe DIC, she received a massive transfusion. The second patient epigastric pain and tachycardia. COVID-19 might have a variety of effects on pregnancy outcome, from vascular and placental involvement to respiratory involvement; there is an association between the coronavirus and hyper-coagulopathy state and coagulopathy like DIC.

Cervical Cancer-Associated Suffering: Estimating the Palliative Care Needs of a Highly Vulnerable Population.

PURPOSETo enable design of optimum palliative care for women with cervical cancer, we studied the most common types of suffering and their severity, prevalence, and duration.METHODSWe first reviewed the literature on the major types, severity, prevalence, and duration of suffering associated with cervical cancer. We then conducted a modified Delphi process with experts in cervical cancer care to supplement the literature. For each type of suffering, we distinguished between decedents (those who die from cervical cancer in a given year) and nondecedents (those who have cervical cancer in a given year but do not die). By applying the suffering prevalence and duration estimates to the number of decedents, nondecedents, and family caregivers in 2017, we were able to estimate their palliative care needs and the intensity of palliative care needed to respond adequately to this suffering.RESULTSThere is a high prevalence among decedents of moderate or severe pain (84%), vaginal discharge (66%), vaginal bleeding (61%), and loss of faith (31%). Among both decedents and nondecedents, there is a high prevalence of clinically significant anxiety (63% and 50%, respectively), depressed mood (52% and 38%, respectively), and sexual dysfunction (87% and 83%, respectively). Moderate or severe financial distress is prevalent among decedents, nondecedents, and family caregivers (84%, 74%, and 66%, respectively). More than 40% of decedents and nondecedents are abandoned by their intimate partners. Most patients experience some combination of moderate or severe physical, psychological, social, and spiritual suffering. In total, 258,649 decedents and 2,558,857 nondecedents needed palliative care in 2017, approximately 85% of whom were in low- and middle-income countries where palliative care is rarely accessible.CONCLUSIONAmong women with advanced cervical cancer, suffering is highly prevalent and often severe and multifaceted.

Inversión uterina no puerperal: primer caso reportado en el Perú

La inversión uterina no puerperal es muy rara. Se comunica un caso asociado con leiomiomatosis. Se trató de una multípara de 45 años que manifestó sangrado vaginal grave, dolor pélvico y sensación de cuerpo extraño vaginal. Se diagnosticó mioma uterino en fase abortiva. Se programó para miomectomía con probable histerectomía abdominal y se encontró inversión uterina completa. Este reporte constituye un caso anecdótico de inversión uterina no puerperal, cuyo tratamiento quirúrgico fue exitoso.

Risk of unscheduled delivery in women with placenta accreta according to planned gestational age at delivery

Background The optimal gestational age at delivery for stable women with suspected placenta accreta is still subject of debate. Objective To estimate the likelihood of vaginal bleeding necessitating expedited delivery in women with placenta accreta according to gestational age at planned cesarean hysterectomy. Study design This was a multicenter cohort study. Singleton pregnancies at risk of placenta accreta because of placenta previa in the setting of prior cesarean delivery were included. Outcomes were compared in cohort of women who had planned cesarean hysterectomy at 34 0/7 − 34 6/7 weeks versus at 35 0/7 − 35 6/7 weeks. The primary outcome was incidence of vaginal bleeding severe enough to necessitate delivery. Results 118 singleton pregnancies with placenta previa in the setting of prior cesarean delivery, and confirmed placenta accreta at the time of delivery were included in the study. Women who had planned cesarean hysterectomy at 34 weeks had lower episodes of vaginal bleeding severe enough to necessitate immediate or emergency delivery (20.6% vs 38.0%; odds ratio (OR) 0.42, 95% confidence interval (CI) 0.19 to 0.96). Eight women (11.8%) in the 34 weeks group and 6 women (12.0%) in the 35 weeks group delivered before the planned date due to onset of spontaneous labor (OR 0.98, 95% CI 0.32 to 3.02). Conclusion In singleton gestations with suspected placenta accreta, planned cesarean hysterectomy at 34 0/7 − 34 6/7 weeks was associated with a decreased chance of unscheduled delivery due to severe vaginal bleeding. Condensation In case of placenta accreta, planned cesarean hysterectomy at 34 weeks was associated with decreased chance of unscheduled delivery due to severe vaginal bleeding.

Factors Associated with Post-Natal Care (PNC) Services Utilization among Adolescent Mothers in Rural Northern Malawi

World Health Organization (WHO) statistics indicate that Sub-Saharan Africa accounts for the vast majority of global maternal deaths. Specifically, maternal deaths among adolescent mothers in rural settings contribute significantly to high maternal mortality. Among others, adolescent mothers’ susceptibility to maternal deaths has been attributed to utilization of post-natal care (PNC) services. Using the Andersen Behavioral Model of Health Services Use, our study sought to examine factors associated with PNC utilization among adolescent mothers in a northern rural district of Malawi. A structured questionnaire was used to conduct interviews among adolescent mothers. A hierarchical logistic regression analysis was carried out using statistical package for social sciences (SPSS). Results show that need factors (severe abdominal pains, vaginal bleeding and obstetric complications) was the most significant factor associated with PNC utilization. Further, the study shows that predisposing factors such as age, educational level, marital status had considerable influence on PNC utilization. Lastly, enabling factors such as family income, adolescent mothers’ occupation, distance to health facility positively influenced mothers’ utilization of postnatal health care. The study recommends to health sector practitioners to use the need factors as the baseline in initiating postnatal health care policies and programs for adolescent mothers, while also paying attention to other factors such as predisposing and enabling because they all have the specific role they play in influencing adolescent mothers’ behavior in accessing postnatal health care.

Cervical Cancer in a 25-Year Old Woman: Case Report.

A case of female 25 years old, married for 5 years, illiterate and she has 3 children from Basrah, Southern Iraq, she had history of recurrent vaginal bleeding during the second and 3rd trimesters in the last pregnancy unfortunately she was missed diagnosed during pregnancy as pregnancy cause of vaginal bleeding and was delivered by caesarian section due to cervical mass and bleeding with no history of follow up after delivery and continuous irregular vaginal bleeding 2 months after delivery till the last consultation when she developed severe pallor and severe vaginal bleeding . The patient was admitted to the Maternal and Child Hospital, Basrah, Iraq. On speculum examination, the cervix was fusiform, enlarged, barrel in shape, friable and bled on touch. Hemoglobin level was 6 gm/dl. Ultrasound and Magnetic Resonance Imaging (MRI) confirmed the presence of a large 7X5X6 Cm. cervical malignant solid mass lesion seen invading the upper third of vagina and lower endometrial cavity. No invasion to the rectum and urinary bladder. Total abdominal hysterectomy, bilateral salpingoophorectomy along with the removal of upper third of the vagina were done after blood correction. The patients agreed that future fertility cannot be preserved. Postoperatively, This finding was proved by the histopathological diagnosis which was invasive non-keratinized, moderately differentiated squamous cell carcinoma of the cervix (FIGO stage IB2).. patient was referred to oncologist for further management.

Diagnosis of uterine torsion during cesarean section

Partial rotation of the uterus up to 45 degrees is a common physiological finding during pregnancy whereas uterine torsion is pathologic and defined as rotation greater than 45 degrees. Torsion of up to 720 degrees has been reported; with most cases occurring between 90 degrees and 180 degrees. While uterine torsion in pregnancy requires emergent intervention, the incidence is unknown. Most cases of uterine torsion are diagnosed intra-operatively at emergent cesarean section following non-specific clinical presentation, such as fetal heart rate decelerations or bradycardia, severe abdominal pain, hypotension, or vaginal bleeding. In this case series, we report on two cases of one woman with gravid uterine levorotation of 180 degrees and another with gravid uterine dextrorotation of 180 degrees.

Menorrhagia in Women After the Administration of Novel Oral ‎Anticoagulants, Like Rivaroxaban: A Case Report

Background: The Novel Oral Anticoagulants (NOACs), despite numerous benefits, such as the ease of use and less drug involvement, provide extensive adverse effects. One of the most significant, but rare side effects of them in women is severe and dangerous bleeding.
 Case presentation: In this study, we reported a case of severe vaginal bleeding (manometric hemorrhage) in a woman receiving rivaroxaban to prevent pulmonary thrombosis.
 Conclusion: The oral anticoagulant rivaroxaban could present a rare adverse effect on women.

Recurrent severe or irregular vaginal bleeding as an indication of arteriovenous malformations

Recurrent severe or irregular vaginal bleeding as an indication of arteriovenous malformations

Knowledge about child birth and postpartum obstetric danger signs and associated factors among mothers in Dale district, Southern Ethiopia

BackgroundGlobally, every day, approximately 800 women die from preventable causes related to pregnancy and childbirth. The majority of these deaths occur after childbirth (post-partum period) mostly within 24 h. Raising awareness of women on obstetric danger sign of childbirth and postpartum, are crucial for safe motherhood initiative and to reduce maternal mortality.MethodsA community based cross sectional study was conducted from December 15, 2017 up to February 10, 2018 on randomly selected sample of 782 women who had at least one delivery in the last 12 months. Multi stage sampling technique was used to select the study participants. Pre tested structured questionnaire was used to collect quantitative data. Bivariate and multivariate logistic regression analyses were performed using SPSS version 20.0 software.ResultsTotal 732 women who had at least one birth prior to this survey were interviewed and making a response rate of 93.6%.The most common spontaneously mentioned danger signs during childbirth was Severe vaginal bleeding by 281 (68.4%). Women who could mention at least two danger signs during child birth and post-partum period were 333 (45.5%), 213(29.1%) respectively. Being urban (AOR = 3.54, 95% of CI: [2.20–5.69] and delivered previous birth at health institution (AOR = 3.35, 95% of CI: [2.38–4.72]) were factors found to be significantly associated with knowledge of danger signs during postpartum. Being Attended secondary level and above (AOR = 2.41, 95% of CI: [1.02–7.76]) and use of ANC during last pregnancy (AOR = 3.63, 95% of CI: [2.51–5.25]), were factors found to be significantly associated with knowledge of danger signs during childbirth.ConclusionsThe level of knowledge about danger signs of child birth and postpartum were low. This indicates that many mothers are more likely to delay in deciding to seek health care. Also, knowledge about danger signs of childbirth and postpartum were affected by place of residence, formal education, use of ANC and place of delivery. Therefore, the identified gap in awareness should be addressed through effective maternal health services by strengthening and designing appropriate strategies including provision of targeted health information, education and communication.

Efficacy of a chitosan tampon in the loop electrosurgical excision procedure: A prospective randomized controlled study

It has been reported that chitosan has a hemostatic effect and an antibiotic activity. This study aimed to evaluate the efficacy and feasibility of using a chitosan tampon (Hemoblock-Tampon) in preventing hemorrhage and enhancing wound healing after the loop electrosurgical excision procedure (LEEP).This single-blind, prospective, randomized study included 62 consecutive patients who underwent LEEP for cervical intraepithelial neoplasia. A chitosan tampon (31 patients; treatment group), or a general tampon (31 patients; control group) was applied to the uterine cervix immediately after LEEP. One patient in the treatment group declined to participate in this study. Thus, 30 patients in the treatment group and 31 patients in the control group completed this study. For objective analysis of hemorrhage in the postoperative 2 weeks, the amounts of bleeding were checked daily with a pictorial blood assessment chart. We evaluated vaginal discharge, abdominal pain, and impairment in daily living during the postoperative 2 weeks using 5 visual analogue scale questionnaires.The bleeding count was significantly lower in the treatment group than in the control group (21.37 ± 16.86 vs. 40.52 ± 16.55, p = 0.0014). The sum of the scores of the 5 questionnaires was significantly lower in the treatment group than in the control group (6.53 ± 2.84 vs. 8.59 ± 2.88, p = 0.0079). The incidence of vaginal discharge was significantly lower in the treatment group than in the control group (20.0% vs. 48.4%, p = 0.0207). According to logistic regression, only the use of chitosan tampon reduced the risk of moderate to severe vaginal bleeding 2 weeks after surgery (Odd ratio, 0.213; 95% confidence interval, 0.06–0.76; p = 0.0172). Complete healing of the uterine cervix occurred in 86.7% of patients in the treatment group and in 61.3% of patients in the control group at 4 weeks after surgery (p = 0.0255).The use of chitosan tampons can reduce hemorrhage, vaginal discharge, abdominal pain, and impairment of daily living after LEEP. Moreover, chitosan tampon may help enhance wound healing.

KAP on Obstetrics Danger Signs of Pregnancy Among ANC Attending Pregnant Mother in Gununno Health Center, Gununo Town, Wolaita Zone, Southern Ethiopia April: 2019

Danger signs of pregnancies are a warning signs that women encounter during pregnancy, child birth and postpartum. It is important, to know this warning signs for women and health care providers to rule out serious complications and initiate treatment immediately. Pregnancy is normal process that results a series of both psychological and physiological changes in pregnant mother. However pregnancy is accompanied with some problems and complications which is life threatening for mother and the fetus. Awareness of obstetric danger sign is first step in accepting appropriate and timely health care service. However there is high maternal death in developing countries due the lack of adequate awareness about danger signs of pregnancy. Yet its factors are not well known in Ethiopia where maternal mortality is high. METHODOLOGY: Descriptive cross sectional study design was conducted for assessment of KAP of obstetric danger sign among pregnant mother at Gununo town, Gununo health center from May10 to June 20, 2019. The pregnant to be interviewed was selected by systematic random sampling ANC registration book at the time of data collection. The total sample size was 420. Structured interviewer administered questionnaire was used to collect data. Data was entered in to STATA 14 statistical software for analysis. Finally, results were presented in texts, graphs and tables. RESULT: A total of 420 pregnant women were included in the study making the response rate 100%. From those who were included in the study 302 (71.56%) identified severe vaginal bleeding at any time during pregnancy as danger sign. In general 248 (58.77%) of the study participants were found to have good knowledge by scoring above the mean value. overall assessment for attitude shows 203 (48.1%) of the study participants had negative attitude by scoring the mean value and below the mean value and 60% were found to have good practice. Conclusion: Knowledge on danger signs during pregnancy is low and greater than half of respondents have unacceptable attitude. The quality of ANC care particularly health education should be evaluated. Further studies are recommended to address the gaps of knowledge and attitude.

Prophylactic intraoperative uterine or internal iliac artery embolization in planned cesarean for pernicious placenta previa in the third trimester of pregnancy: An observational Study (STROBE compliant).

The aim of this study was to evaluate the efficacy and safety of prophylactic intraoperative bilateral uterine or internal iliac artery embolization in planned cesarean for pernicious placenta previa in the third trimester of pregnancy.The patients with pernicious placenta previa were retrospectively included from January 2011 to May 2018, being divided into embolization group and control group. Intraoperative uterine artery embolization (UAE) or internal iliac artery embolization (IIAE) was undertaken to stop intrapartum and postpartum hemorrhage in embolization group.There were no significant differences on age, pregnancy times, gestational age, neonatal weight, neonatal asphyxia, prenatal bleeding, placental implantation, and mortality between embolization group and control group (P > .05). The amount of intraoperative and postoperative bleeding in embolization group was significantly greater than that in control group (P < .05). However, the hysterectomy rate in the embolization group was significantly lower than that in the control group (P < .05). Two (6.25%, 2/32) cases had undergone the second time embolotherapy after 8 hours of cesarean surgery because of severe vaginal bleeding. One case (3.13%, 1/32) died of diffuse intravascular coagulation because of hemorrhagic shock in embolization group. Transient and self-remitted lumbosacral pain was present in 28 (95%, 28/32) patients and no other severe interventional complications were reported in embolization group. All babies in 2 groups were healthy at half to 5 years’ follow-up.The prophylactic intraoperative embolization of bilateral UAE or IIAE may be an effective strategy to treat intractable peripartum hemorrhage and preserve the fertility in patients with pernicious placenta previa.

2916 Laparoscopic Techniques for Open Hysterectomy

Video Objective We propose the use of laparoscopic techniques in an open hysterectomy for a large multi fibroid uterus to decrease operating time, increase visualization, and decrease trauma. Setting 53 y/o G4P3 presented c/o severe abdominal pain and heavy vaginal bleeding. Patient presented to multiple emergency departments due to pain and bleeding. Found to have multi-fibroid uterus with one predominant degenerating fibroid. Pt desired definitive surgical management but due to the size of the uterus, it required an open technique. Pt was admitted to the hospital for pain control and surgical management. Interventions Total abdominal hysterectomy with laparoscopic techniques. Conclusion Using laparoscopic techniques in an open hysterectomy can improve visualization and allow us to take advantage of the benefits of laparoscopic surgery when dealing with a large fibroid uterus.

Trans-arterial embolization of acquired uterine arteriovenous malformation after Cesarean section: A case series

BackgroundAcquired uterine arteriovenous malformation (AVM) is a rare condition due to traumatic episodes in cesarean section. The patient can suffer from life-threatening hemorrhage or recurrent vaginal bleeding. Establishing this diagnosis is difficult, often misdiagnosed due to lack of information and number of cases. Trans-Arterial Embolization (TAE) procedure is rarely performed in our center. All of the cases were found with history of massive bleeding and diagnosed lately after recurrent bleeding history. Even though promising, one of our cases failed to be managed with TAE. It is important to diagnose early symptoms of AVM in order to prevent the life threatening event.Case presentationIn these case series, four cases of AVMs after cesarean procedures will be reviewed. One could be diagnosed in less than a month but the other three took several months. The symptom of vaginal bleeding might occur a few weeks after the procedure is done, and most patients need transfusion and hospitalization. Three out of four patients were initially sent to the hospital in order to recover from shock condition, and one patient was sent for a diagnostic procedure. AVMs diagnostic was established with ultrasound with or without angiography. Three of our cases were succeeded by performing TAE procedure without further severe vaginal bleeding. One case failed to be treated with embolization and had to proceed with hysterectomy.ConclusionAVM should be considered early-on in patient with abnormal uterine bleeding and history of cesarean section. Embolization is still the first-choice treatment of AVMs, otherwise definitive treatment is hysterectomy in a patient without fertility need, or impossible to perform TAE.

Prekallikrein and high molecular weight kininogen deficiency in Oman: a challenging diagnosis in mucosal bleeding

Background: Prekallikrein (PK) and high molecular weight kininogen (HMWK) are contact factors that are involved in the intrinsic pathway of the coagulation cascade. Deficiency of PK or HMWK are known to be associated with prolonged a PTT, but no clinical bleeding. However, rare cases of PK deficiency have been reported to be associated with mucosal bleeding. Objective: To report on epidemiological and clinical characteristics of Omani patients with PK and HMWK deficiency, focusing on one symptomatic case. Patients and methods: We reviewed the files of Omani patients who had persistently prolonged a PTT that proved to be secondary to PK or HMWK deficiency over a period of ten years. Results: Eight cases (three with PK, five with HMWK deficiency) were identified. All but one case were asymptomatic. A thirteen year-old female with Hashimoto thyroiditis who presented with easy bruising, severe prepubertal vaginal bleeding and recurrent hematemesis proved to have prekallikrein deficiency. Acquired vWD, coagulation factors deficiency, lupus anticoagulant, platelet dysfunction were ruled out. No local cause of bleeding could be identified even after four endoscopic examinations, Meckel’s diverticulum scintigraphy and CT angiography of the abdomen. Conclusion: PK and HMWK are underestimated in Oman. Most cases were incidentally detected. They significantly impact medical costs, related to extensive laboratory testing and undue delay in planned surgical procedures. Some cases with clinical bleeding impose a diagnostic challenge.

Maternal severe stressful life events and risk of abnormal vaginal bleeding among urban Chinese pregnant women

Objective: The objective of this study is to assess whether maternal stressful life events are associated with increased risk of vaginal bleeding in urban China.Methods: We implemented a cross-sectional study to examine the association between maternal severe stressful life events and vaginal bleeding in early pregnancy. Information was collected from an urban area and 956 participants were involved in final analysis. Multivariable logistic model was used to estimate the adjusted odds ratio (OR) and 95% confidence interval (95% CI) controlling for confounders.Results: In total, 219 of the 956 participants were reported vaginal bleeding. Maternal stressful life events would increase the chance of vaginal bleeding with a crude OR of 2.14 (95% CI, 1.53–2.99). After adjustment for potential variables, the association remains significant (adjusted OR, 2.22; 95% CI, 1.56–3.16), and stratification analysis shows parity is an influence factor. The frequency of maternal stress and vaginal bleeding exist a dose–response relationship.Conclusion: Maternal stressful life events are associated with the risk of vaginal bleeding in urban China. The parity status influences their association.