TITLE:
Predicting adverse maternal and perinatal outcome after threatened miscarriage
AUTHORS:
Swati Agrawal, Susheela Khoiwal, Kumar Jayant, Rajendra Agarwal
KEYWORDS:
First-Trimester Bleeding; Threatened Miscarriage; Maternal Outcome; Perinatal Outcome; Subchorionic Hematoma
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.4 No.1,
December
26,
2013
ABSTRACT: Objectives: Threatened
miscarriage is the most common complication of pregnancy, occurring in 20% - 25%
of ongoing pregnancies. The purpose is to study maternal and perinatal outcome in women with threatened miscarriage. Methods: A prospective study was
conducted over a period of 20 months in the Department of Obstetrics and
Gynaecology, Pannadhay Mahila Chikitsalaya, a tertiary care center in Udaipur,
India. It included a cohort of pregnant patients with a history of threatened
miscarriage during the first twenty weeks of pregnancy. They were registered,
followed up prospectively at antenatal clinics and delivered in the same
hospital. For the purpose of comparison, another group of booked patients
(controls) without a history of threatened miscarriage were recruited,
similarly scanned and followed throughout pregnancy and labour. All women were
matched for age, parity, social class, BMI and gestational age at booking. Discrete
variables were taken as counts (or frequencies) and were evaluated by
Chi-square test. Continuous variables with normal distribution were presented as mean ± standard deviation (SD) and
were compared by unpaired Student’s t test. Data were fed into a
Microsoft Excel worksheet and were analyzed by using the SPSS ver.17 (SPSS
Inc., Chicago, IL, USA). p-value >
0.05 was considered statistically significant. Results: Out of 62 cases, 13 (21%) patients spontaneously
aborted after diagnosis of threatened miscarriage.
Women with threatened miscarriage had a significantly higher incidence
of low lying placenta (p = 0.02) when
compared with those without firsttrimester bleeding. They were more likely to
experience PROM (p = 0.02), preterm
delivery (p = 0.02) and to have
babies with low Birthweight (p = 0.03). Conclusion: Pregnancies complicated
by threatened miscarriage are at a higher risk for obstetric complications.