A study of outcome of pregnancy in first and second trimester bleeding

AIMS AND OBJECTIVES: 1. To determine the outcome of pregnancy in first and second trimester vaginal bleeding. 2. To study the maternal and fetal outcome and its association and complications associated with first and second trimester vaginal bleeding. METHODOLOGY: Study Centre : Study was conducted in Institute of Obstetrics and Gynecology, Govt. Women and Children Hospital, Madras Medical College, Chennai. Study Design : Prospective Cohort Study. Period of Study :10 months (November 2016 – August 2017). Sample size :100. Inclusion criteria: All cases of singleton gestation with vaginal bleeding up to24 weeks [by LMP and confirmed by ultrasound] Exclusion criteria: Multiple gestation, Chronic medical illness like diabetes or hypertension, Preeclampsia, Gestational trophoblastic disease, Ectopic pregnancy, Bleeding diathesis. Procedure: Patients presenting with bleeding be in institute of obstetrics and gynaecology are the cases whom are followed up prospectively until the end of pregnancy Control group consists of age matched women who booked for antenatal care in the hospital during the same period. Characteristics of all the patients related to their age, gravidity, period of gestation, ultrasonic results, duration and amount of bleed are collected through self-administered structured questionnaire. The potential confounding factors like maternal age, gravidity, previous recurrent abortions, and previous preterm delivery are matched. Outcome data are planned to obtain from hospital notes and confirmed by telephone follow up where ever necessary Cases and control are matched, Outcome variables were tested using Chi square. RESULTS: In this study, the outcome observed statically significant p value is 0.001.The patient with first and second trimester bleeding have maternal outcome like IUGR, PROM, LBW, Preeclampsia and miscarriage. The patients with bleeding will have more neonatal complications like LBW, RDS and Prematurity. CONCLUSION: Women with vaginal bleeding during first and second trimester have a high risk of unwanted pregnancy outcome and they should be hospitalized. They require better care and have to be refer to well-equipped medical centre to reduce the risk of maternal and neonatal complications and also inform health care professionals that this is a warning signal to consider such cases as high risk pregnancies and treat them accordingly