An Observational Prospective Evaluation of Perinatal Outcome in Early and Late Pregnancy Haemorrhage
Authors/Creators
- 1. Assistant Professor, Department of Gynaecology, Shri Ramkrishna Institute of Medical Sciences and Sanaka Hospital, Durgapur, Durgapur, West Bengal, India
Description
Aim: The aim of the present study was to assess the perinatal outcome in early pregnancy hemorrhage and late pregnancy hemorrhage. Material & Methods: An observational prospective study performed within span of 1 year in the Department of Obstetrics and Gynaecology. Total number of 200 women with bleeding per vaginal during pregnancy was enrolled in the study. Results: Maximum number of cases was concentrated in 26 – 30 years of age with mean age of 28 years. Maximum number of cases was multigravida. Majority of cases were unbooked and booking status was minimal especially with early bleeding group. Maximum numbers of cases were of threatened abortion and minimum were of bleeding due to cervical changes in early pregnancy group. And among late pregnancy group, maximum cases were of placenta previa and minimum were of vasa previa, polyps and carcinoma. Due to perinatal asphyxia, most of the newborns had low APGAR scores at 1 and 5 minutes in late pregnancy bleeding cases as compared to early pregnancy bleeding group. Live newborns of early pregnancy bleeding group showed no significant increase in the complications as compared to late pregnancy bleeding group. Live newborns of late pregnancy bleeding group suffered from a variety of complications of preterm delivery and perinatal asphyxia and so the rate of NICU admissions was also higher. Conclusion: Vaginal bleeding at any stage of pregnancy is an alarming event and can be potentially life-threatening to mother and fetus. Obstetrician should ensure that patient delivers in a well-equipped centre with NICU facilities and expertization of neonatologist.
Abstract (English)
Aim: The aim of the present study was to assess the perinatal outcome in early pregnancy hemorrhage and late pregnancy hemorrhage. Material & Methods: An observational prospective study performed within span of 1 year in the Department of Obstetrics and Gynaecology. Total number of 200 women with bleeding per vaginal during pregnancy was enrolled in the study. Results: Maximum number of cases was concentrated in 26 – 30 years of age with mean age of 28 years. Maximum number of cases was multigravida. Majority of cases were unbooked and booking status was minimal especially with early bleeding group. Maximum numbers of cases were of threatened abortion and minimum were of bleeding due to cervical changes in early pregnancy group. And among late pregnancy group, maximum cases were of placenta previa and minimum were of vasa previa, polyps and carcinoma. Due to perinatal asphyxia, most of the newborns had low APGAR scores at 1 and 5 minutes in late pregnancy bleeding cases as compared to early pregnancy bleeding group. Live newborns of early pregnancy bleeding group showed no significant increase in the complications as compared to late pregnancy bleeding group. Live newborns of late pregnancy bleeding group suffered from a variety of complications of preterm delivery and perinatal asphyxia and so the rate of NICU admissions was also higher. Conclusion: Vaginal bleeding at any stage of pregnancy is an alarming event and can be potentially life-threatening to mother and fetus. Obstetrician should ensure that patient delivers in a well-equipped centre with NICU facilities and expertization of neonatologist.
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IJTPR,Vol13,Issue10,Article74.pdf
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Additional details
Dates
- Accepted
-
2023-08-09
Software
References
- 1. Wittels KA, Pelletier AJ, Brown DF, Camargo Jr CA. United States emergency department visits for vaginal bleeding during early pregnancy, 1993-2003. American Journal of Obstetrics and Gynecology. 2008 May 1;198(5): 523-e1. 2. Say L, Chou D, Gemmill A, Tunçalp Ö, Moller AB, Daniels J, et al. Global causes of maternal death: a WHO systematic analysis. The Lancet Global Health. 2014; 2(6): 323-33. 3. Agarwal S, Ranjan M, Sachan S, Kumar L. Antepartum hemorrhage and its maternal and perinatal outcome: An experience at a hospital in North India. Journal of Family Medicine and Primary Care. 2023 Dec 1;12(12):3204-8. 4. Cunningham F, Leveno K, Bloom S, Hauth J, Gilstrap L, Rouse D et al. Obstetrical haemorrhage. Williams Obstetrics. 23rd Edition. New York: McGraw Hill; 2009. 5. Ellen Sakornbut, Lawrence Leeman, Patricia Fontaine. Late Pregnancy Bleeding. Am Fam Physician. 2007 Apr 15;75(8):1199-1206. 6. Sheiner E, Shoham-Vardi I, Hadar A, Hallak M, Hackmon R, Mazor M. Incidence, obstetric risk factors and pregnancy outcome of preterm placental abruption: A retrospective analysis. J Matern Fetal Neonatal Med 2002;11:34-9. 7. Cunningham F, Leveno KJ, Bloom SL, Dashe JS, Hoffman BL, Casey BM, Spong CY. eds. Obstetrical Hemorrhage. Williams Obstetrics, 25e. McGraw Hill; 2018. 8. South Australian Perinatal Practice Guidelines. 9. Lakshmipriya K, Vijayalakshmi V, Padmanaban S. A study of maternal and fetal outcome in Antepartum haemorrhage. International Journal of Clinical Obstetrics and Gynaecology 2019; 3(1): 96-99. 10. Hassan W, Abu-Helalah M, Salam A, Elhakim A, Bayazeed H, Latif S, Rehmani R, Das TK. Incidence of early pregnancy bleeding in the Eastern region of Saudi Arabia. International Journal of Reproduction, Contraception, Obstetrics and Gynecology. 2016 May 1;5(5): 13 93. 11. Sheikh F, Khokhar SA, Sirichand P, Shaikh RB. A study of antepartum haemorrhage: Maternal and Perinatal outcomes. Medical Channel. 2010 Apr;16(2):268-71. 12. Singhal S, Nymphaea NS, Nanda S. Maternal and perinatal outcome in antepartum hemorrhage: A study at a tertiary care referral institute. Internet J Gynecol Obstet. 2008;9(2) 55 80. 13. Das B. Antepartum haemorrhage in three decades. J ObstetGynae India. 1975;25:636-7. 14. Gilliam M, Rosenberg D, Davis F. The likelihood of placenta previa with greater number of cesarean deliveries and higher parity. Obstetrics & Gynecology. 2002 Jun 1;99(6):976-80. 15. William MA, Mittewdro PR. Increasing maternal age a determinant for placenta previa, more important than increasing parity? J Reprod Med 1993;38:425-8. 16. Ananth CV, Wilcox AJ, Savitz DA, Bowes Jr WA, Luther ER. Effect of maternal age and parity on the risk of uteroplacental bleeding disorders in pregnancy. Obstetrics & Gynecology. 1996 Oct 1;88(4):511-6. 17. Weiss JL, Malone FD, Vidaver J, Ball RH, Nyberg DA, Comstock CH, Hankins GD, Berkowitz RL, Gross SJ, Dugoff L, TimorTritsch IE. Threatened abortion: a risk factor for poor pregnancy outcome, a populationbased screening study. American journal of obstetrics and gynecology. 2004 Mar 1;190 (3) :745-50. 18. Patel BI, Trivedi V. Threatened abortion outcome in relation to intrauterine clot site and not only volume. International Journal of Gynecology & Obstetrics. 2000;70:D44-.19. Alcazar JL, Ruiz. Uteroplacental circulation in patients with first trimester threatened abortion. Fert Steril.2000 Jan;73(1):130-135 20. Das AG, Gopalan S, Dhahwal LK. Fetal growth and perinatal outcome of pregnancies continuing after threatened abortion. Australian and New Zealand journal of obstetrics and gynaecology. 1996 May;36(2):135-9. 21. Mulik V, Bethel J, Bhal K. A retrospective population-based study of primigravid women on the potential effect of threatened miscarriage on obstetric outcome. Journal of Obstetrics and Gynaecology. 2004 Apr 1;24(3):249- 53. 22. Szekeres-Bartho J. Immunological relationship between the mother and the fetus. International reviews of immunology. 2002 Jan 1;21(6):471- 95. 23. Yang J, Hartmann KE, Savitz DA, Herring AH, Dole N, Olshan AF, Thorp Jr JM. Vaginal bleeding during pregnancy and preterm birth. American journal of epidemiology. 2004 Jul 15;160(2):118-25. 24. WILLIAMS MA, HICKOK DE, ZINGHEIM RW, MITTENDORF R, KIMELMAN J, MAHONY BS. Low birth weight and preterm delivery in relation to early-gestation vaginal bleeding and elevated maternal serum alphafetoprotein. Obstetrics & Gynecology. 1992 Nov 1;80(5):745-9. 25. Jouppila P. Vaginal bleeding in the last two trimesters of pregnancy a clinical and ultrasonic study. Acta Obstetricia et Gynecologica Scandinavica. 1979 Jan 1;58(5):461-7.