MATERNAL & PERINATAL OUTCOME IN PREGNANT WOMEN PRESENTING FIRST TRIMESTER VAGINAL BLEEDING
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Keywords
First-trimester bleeding, intrauterine death, preterm birth, maternal complications, perinatal outcomes.
Abstract
First-trimester vaginal bleeding complicates 15–25% of pregnancies and is associated with adverse outcomes, including miscarriage, preterm birth, and intrauterine death (IUD). Despite its clinical significance, limited local data exist on its impact in our population.
Objective: To evaluate the maternal and perinatal outcomes of pregnancies complicated by first-trimester vaginal bleeding.
Methods: A case series study was conducted at Mardan Medical Complex from July 2019 to January 2020, involving 204 women with first-trimester bleeding (≤12 weeks) and confirmed fetal cardiac activity. Exclusion criteria included chronic medical conditions, cervical pathology, and fetal anomalies. Data were analyzed using SPSS v23, with p<0.05 considered significant.
Results: The mean maternal age was 28 ± 5.18 years, with 41.6% (n=86) aged 20–25 years. Most pregnancies ended in termination (84.1%, n=172), while 9.3% (n=19) resulted in normal vaginal delivery and 6.3% (n=13) in cesarean section. Perinatal outcomes revealed IUD in 85.3% (n=174), live births in 10.29% (n=21), and preterm delivery in 4.41% (n=9). Maternal complications included missed abortion (84.31%, n=172), PROM (14.21%, n=29), and APH (1.47%, n=3). Age stratification showed higher IUD rates in women aged 21–30 years (91.72%) vs. 30–40 years (73.23%, p=0.45), but maternal complications (PROM, APH) were significantly higher in older women (p=0.017). Gestational age strongly influenced outcomes (p=0.000), with 100% IUD at 4–12 weeks vs. 67.74% live births at 29–40 weeks.
Conclusion: First-trimester vaginal bleeding is a significant predictor of poor perinatal outcomes, particularly IUD. Advanced maternal age and early gestational bleeding correlate with higher complications. Close monitoring and early intervention are essential for improving fetomaternal outcomes in high-risk pregnancies.
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Dr. Uzma Wahid
MBBS,FCPS (Obstetrics & Gynecology) Consultant Gynaecologist DHQ Hospital Nowshehra
Dr. Rekha
MBBS,FCPS (Obstetrics & Gynecology) Senior Woman medical officer Liaquat University Hospital Hyderabad
Dr. Uzma Mubarak
MBBS,FCPS (Obstetrics & Gynecology) Women Medical Officer DHQ Hospital Nowshehra
Dr. Madeeha Khan
MBBS, FCPS (Obstetrics & Gynecology) Consultant Gynaecologist DHQ Hospital Mardan
Dr. Musarrat Qureshi
MBBS, FCPS (Obstetrics & Gynecology) Women Medical Officer Health Department Peshawar
Dr. Mehwish Shafi
MBBS, FCPS (Obstetrics & Gynecology) Consultant Gynaecologist DHQ Hospital Mardan
Khadija Javeed
Final year MBBS Liaquat University of Medical and Health Sciences Jamshoro
Mustaqim Memon
Final year MBBS Liaquat University of Medical and Health Sciences Jamshoro
Maryam Qureshi
Final year (MBBS) Liaquat University of Medical and Health Sciences Jamshoro
Muqtada Memon
Final Year (MBBS) Liaquat University of Medical and Health Sciences Jamshoro