Sakshi Yadav 3rd Year Resident, Department of Obstetrics and Gynecology, Bharati Vidyapeeth Deemed University, Kothrud, Pune 411038, Maharashtra, India
Y S Kulkarni Associate Professor, Department of Obstetrics and Gynecology, Bharati Vidyapeeth Deemed University, Kothrud, Pune 411038, Maharashtra, India
Address for correspondence: Sakshi Yadav, 3rd Year Resident, Department of Obstetrics and Gynecology, Bharati Vidyapeeth Deemed University, Kothrud, Pune 411038, Maharashtra, India E-mail: sakshiya14@gmail.com
This license
enables reusers to distribute, remix, adapt, and build upon the material in any
medium or format for noncommercial purposes only, and only so long as
attribution is given to the creator.
Sakshi Yadav, Y S Kulkarni/A Study on Pregnancy Outcomes in Patients with First Trimester Vaginal Bleeding/Indian J Obstet Gynecol. 2022;10(4):191–197.
Timeline
Received : March 21, 2022
Accepted : April 26, 2022
Published : December 25, 2022
Abstract
Bleeding in first trimester of pregnancy poses a risk to embryo. It can be a natural symptom of implantation, sign of spontaneous abortion, or of pathologic condition like ectopic pregnancy/gestational trophoblastic illness.4 Aim: To assess the etiology and outcome of first trimester bleeding. Objectives: (1) To study the etiology for first trimester bleeding. (2) To study the incidence of various etiological factors. Settings and design: This is the prospective observational study carried out in a tertiary health care centre over 2 years from October 2019 to october 2021. Materials and methods: This study was conducted on women with complaints of vaginal bleeding in first trimester of pregnancy. The methodology were explained to the women and valid informed written consent was recorded. The ethical clearance was obtained from ethical review committee of the tertiary care centre. After taking a detailed history and physical examination, the patient will undergo a urine pregnancy test, on confirmation she will be sent for a TVS scan depending upon the USG report further management and follow-up will be decided. Conclusion: Bleeding in first trimester doesn’t necessarily lead to miscarriage, but causes anxiety to the patient. Women and obstetricians should consider the outcome of continued pregnancies after the first trimester bleeding when planning antenatal care and clinical interventions. We need more researches on this to improve our better understanding and knowledge so that we can better plan the continued pregnancy as well as council the patient in better way.
References
1. Zhila Amir Khani, MeisamAkhaghdhoust Media Abedian,Gelreh Rabie, Salehi, maternal and perinatal outcome in pregnant women with first trimester vaginal bleeding. J Fam Reprduct Health. 2013;7(2):57-61.
2. Kavyashree HS, Rajeshwari K. A study on pregnany outcome in patients with first trimester vaginal bleeding. Int J ReprodContaceptObstetGynec ol2019;8:820-4.
3. Dogra V, Paspulati RM, Bhatt S. First trimester bleeding evaluation. Ultrasound Q. 2005;21(2):69-85.
4. Aziz S, Cho RC, Baker DB, Chhor C, Filly RA. Fivemillimeter and smaller embryos without embryonic cardiac activity:outcomes in women with vaginal bleeding. J Ultrasound Med. 2008;27(11):1559-61.
5. Reem Hasan, Donna D. Baird, Amy H. Herring, Andrew F. Olshan, Mishele L. Jonsson Funk, and KatherineE. Hartmann. Patterns and predictors of vaginal bleeding in the first trimester of pregnancy. Ann Epidemiol. 2010;20(7):524-31.
6. Deutchman M, Tubay AT, Turok D. First trimester bleeding. Am Fam Physician.2009;79(11):985- 94.
7. Hasan R, Baird D, Herring A, et al. Association between first-trimester vaginal bleeding and miscarriage. Obstet Gynecol. 2009; 114(4):860-867.
9. Smith KE, Buyalos RP. The profound impact of patient age on pregnancy outcome after early detection of fetal cardiac activity. FertilSteril. 1006; 65(1):35-40.
10. Barnhart KT, Sammel MD, Rinaudo PF, Zhou L, Hummel AC, Guo W. Symptomatic patients with an early viable intrauterine pregnancy: hCG curves redefined. Obstet Gynecol. 2004;104:50-55.
11. Horne A, McBride R, Denison F. A normally rising hCG does not predict live birth in women presenting with pain and bleeding in early pregnancy. Eur J ObstetGynecolReprod Biol. 2011; 156(1):120-121.
12. American Institute of Ultrasound Medicine. AIUM practice guidelines for the performance of obstetric ultrasound examinations. J Ultrasound Med. 2010; 29(1):157-166.
13. Bennett GL, Bromley B, Lieberman E, et al. Subchorionic hemorrhage in firsttrimester pregnancies: prediction of pregnancy outcome with sonography. Radiology. 1996; 200:803-806.
14. Albayram F, Hamper UM. First trimester obstetric emergencies: spectrum of sonographic findings. J Clin Ultrasound. 2002; 30(3):161-177.
15. Tong S, Kaur A, Walker SP, et al. Miscarriage risk for asymptomatic women after a normal first-trimester prenatal visit. Obstet Gynecol. 2008; 111(3):710-714.
16. Jeve Y, Rana R, Bhide A, et al. Accuracy of firsttrimester ultrasound in the diagnosis of early embryonic demise: a systematic review Ultrasound Obstet Gynecol. 2011; 38:489-496.
17. Bae S, Karnitis J. Triple ultrasound markers including fetal cardiac activity are related to miscarriage risk. FertilSteril. 2011; 96(5):1145-1911.
18. Condous G, Timmerman D, Goldstein S, et al. Pregnancies of unknown location: a consensus statement. Ultrasound Obstet Gynecol. 2006; 28:121-1.
19. Barnhart K, van Mello N, Bourne T, et al. Pregnancy of unknown location: a consensus statement of nomenclature, definitions, and outcome. FertilSteril. 2011; 95(3):857-866.
20. Wahabi HA, Fayed AA, Esmaeil SA, et al. Progestogens for treating threatened miscarriage. Cochrane Pregnancy and Childbirth Group. Cochrane Database Syst Rev. 2011;(8):CD 005943.
Data Sharing Statement
There are no additional data available. All raw data and code are available upon request.
Funding
This research received no funding.
Author Contributions
All authors contributed significantly to the work and approve its publication.
Ethics Declaration
This article does not involve any human or animal subjects, and therefore does not require ethics approval.
Acknowledgements
We would like to express our gratitude to the patients, their families, and all those who have contributed to this study.
Conflicts of Interest
No conflicts of interest in this work.
About this article
Cite this article
Sakshi Yadav, Y S Kulkarni/A Study on Pregnancy Outcomes in Patients with First Trimester Vaginal Bleeding/Indian J Obstet Gynecol. 2022;10(4):191–197.
This license
enables reusers to distribute, remix, adapt, and build upon the material in any
medium or format for noncommercial purposes only, and only so long as
attribution is given to the creator.
This license
enables reusers to distribute, remix, adapt, and build upon the material in any
medium or format for noncommercial purposes only, and only so long as
attribution is given to the creator.