Obstetrical outcome of pregnancy complicated with first trimester bleeding and subchorionic hematoma

Agarwal, Kiran; Ritu, Ritu; Singh, Amrita; Singh, Anjali; Mishra, Amrita

doi:10.18203/2320-1770.ijrcog20195640

Cited by 3 publications

(4 citation statements)

References 15 publications

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“…A hematoma may generate a weak spot where the placenta can further separate from the uterine wall, leading to placental abruption, especially if it is located retroplacentally. 6 If the gestational sac does survive, however, reattachment to the endometrial wall might be sufficient to continue the pregnancy without any additional negative effects.…”

Section: Discussionmentioning

confidence: 99%

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Association of volume of first trimester subchorionic hemorrhage with pregnancy outcome

Bairwa

Hooja

Sharma

et al. 2023

Int J Reprod Contracept Obstet Gynecol

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Background: Vaginal bleeding during the first trimester of pregnancy may or may not be associated with subchorionic hemorrhage (SCH). The volume of SCH may affect foetal growth or development. The aim of the study was to determine the impact of first trimester pregnancy SCH on pregnancy outcome. Methods: 151 women each in two groups (with and without SCH), all with first trimester bleeding were enrolled, monitored throughout pregnancy and outcome noted. Results: 72.8% women with SCH and 78.1% women without SCH gave birth to a live neonate. The relative risk of pregnancy wastage (spontaneous abortion, antepartum or intrapartum stillbirth) for the women with SCH was 1.22 (95% CI 0.81-1.82; p value =0.33) as compared to those with no SCH. 97% of women with SCH>10 ml had pregnancy wastage (mostly aborted before 20 weeks), 40% of women with SCH>5-10 ml had pregnancy wastage (p<0.001). Conclusions: The mere presence of SCH did not increase the risk of adverse pregnancy outcomes. However, a large volume of SCH significantly increased the risk of pregnancy wastage in comparison to a smaller SCH.

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Section: Discussionmentioning

confidence: 99%

“…Approval from the institute's ethical committee was taken. The minimum required sample size was calculated at 95% confidence level assuming 73.33% sensitivity, sample size of 151 cases in each group was taken as found in article of Agarwal et al 6…”

Section: Introductionmentioning

confidence: 99%

Association of volume of first trimester subchorionic hemorrhage with pregnancy outcome

Bairwa

Hooja

Sharma

et al. 2023

Int J Reprod Contracept Obstet Gynecol

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“…Heavy bleeding occurred mainly in incomplete and complete abortions, while spotting and light bleeding occurred in threatened abortions, viable intra uterine pregnancy and missed abortion. Threatened abortions, incomplete abortion, missed abortion and ectopic pregnancy presented with bleeding, haemorrhage although increased risk of preeclampsia, fetal growth limits, premature pregnancy and lower abdominal pain 4,5,16 . The diagnosis was confirmed on ultrasound 17,18 .…”

Section: Discussionmentioning

confidence: 99%

“…Pregnancies with first trimester bleeding and subchorionic hematoma were associated with similar risk of miscarriage and antepartum haemorrhage although increased risk of preeclampsia, fetal growth limits, premature pregnancy, non-reassuring fetal heart rhythm, cäsarean delivery and low birth weight. [5][6][7]…”

Section: Introductionmentioning

confidence: 99%

Observational Study of Patients Presenting with Bleeding in First Trimester

2020

IJFMT

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Objective: First trimester is an important period during which there is risk of bleeding and may lead to spontaneous abortion. More than 80% spontaneous abortions occur in first trimester. The aim of this study was to determine the causes of first trimester bleeding.Method: This was a cross sectional descriptive study conducted at Shalinitai Meghe hospital and Research centre Hingana, Nagpur during January 2020 to June 2020. The patients presenting to OPD with history of bleeding or spotting per vaginum, positive urine pregnancy test and less than 12 weeks of gestation were included in this study. Clinical examination and ultrasonography was done.Result: Most of the patients presented with moderate bleeding and associated pain. The duration of bleeding was 2 to 5 days. Majority of cases were between 4-8 weeks (69.5%). History of prior miscarriage was present in 23.7%. 61% of cases were anemic. Threatened abortion was most common in patients presenting with bleeding per vaginum (in 47.5%). 18.6% patients were with incomplete abortion and 11.8% had complete abortion. There were 2 cases of unruptured ectopic pregnancy and 1 case of ruptured ectopic pregnancy. Salpingectomy was done in all the 3. Dilatation and evacuation was done in 12 cases. Gestational sac was present in 52 cases and the appearance was normal in 53.8% cases. Yolk sac was present in 65.4% cases. Fetal pole and cardiac activity was seen in 57.7%cases. Conclusion:Bleeding in first trimester of pregnancy is the common complaint with which the pregnant women presents to the health care worker. The commonest cause is the threatened abortion. Other causes are incomplete, complete and missed abortions. Bleeding in early pregnancy may be early presentation of a serious situation like ectopic pregnancy. Ultrasonography, especially the Trans Vaginal is very important in concluding the causes of bleeding. Pregnant women should be educated in the first visit to antenatal OPD itself for the symptoms like bleeding per vaginum and to seek help from health care worker as soon as possible.

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Analysis and Evaluation of First Trimester Bleeding – A Retrospective Study

Stalin

Anuradha²,

Shinde³

2021

ijsr

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Introduction : About one fourth of pregnant women present with bleeding in the rst trimester .The four major sources of nontraumatic bleeding in early pregnancy are ectopic pregnancy, miscarriage (threatened, inevitable, incomplete, complete), implantation of the pregnancy, cervical, vaginal, or uterine pathology (eg, polyps, inammation/infection, trophoblastic disease). Although 50% of cases presenting with vaginal bleeding continue to have a normal healthy pregnancy, but the maternal anxiety about risk of miscarriage should be assessed and counselled. The present study is an overview of etiologies and evaluation of bleeding upto 12 weeks of gestational age. Aim:To evaluate the incidence and etiology of rst trimester bleeding. Objective: To correlate the association between rst trimester bleeding and miscarriage. Methodology:A retrospective study among pregnant women with rst trimester bleeding was conducted for a period of 1 year at Chettinad hospital and Research Institute.Detailed History taking and pelvic examination was done for 139 patients.Specic blood investigation along with Transvaginal USG probe 3-5 MHz was performed and appropriate treatment was given. Results: Out of 900 pregnant women attending the out patient (OP) over a period of one year, 139 patients presented with rst trimester bleeding , incidence being 15.44%. The present study suggest that 41.007% women had miscarriage following rst trimester bleeding . It is depicted that 20.14% of women had history of previous abortions and 12.23% had history of bleeding in previous pregnancy. The major cause of bleeding in the rst trimester in our study was threatened abortion (32.37%). Conclusion :We conclude that the present study helps in giving appropriate treatment to women presenting with rst trimester bleeding . Ultrasonography plays a key role in the diagnosis of cause of bleed . Early care and close monitoring will inevitably improve pregnancy outcome .

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Obstetrical outcome of pregnancy complicated with first trimester bleeding and subchorionic hematoma

Cited by 3 publications

References 15 publications

Association of volume of first trimester subchorionic hemorrhage with pregnancy outcome

Association of volume of first trimester subchorionic hemorrhage with pregnancy outcome

Observational Study of Patients Presenting with Bleeding in First Trimester

Analysis and Evaluation of First Trimester Bleeding – A Retrospective Study

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