The Incidence and Fetal Outcome of Threatened Miscarriage at a Tertiary Health Centre in Sub-Saharan Africa

Abstract

Background: Threatened miscarriage or pregnancy-related vaginal bleeding in the first half of pregnancy without cervical dilatation, is associated with adverse pregnancy outcomes and its incidence varies from one centre to another. Objective: The main objective was to determine the incidence and fetal outcome of threatened miscarriage at the Benue State University Teaching Hospital (BSUTH), Makurdi. Methodology: This was a cross-sectional study of 90 consecutive, eligible pregnant women presenting with threatened miscarriage at the Obstetrics and Gynaecology unit of Benue State University Teaching Hospital over a two-year period. After discharge, they were followed up at the antennal clinic to determine the fetal outcome of their pregnancies. Data was analyzed using SPSS version 25.0 Results: There were 504 gynaecological admissions with 90 threatened miscarriages giving an incidence of 17.9%. The mean age of the subjects was 28.8 (±5.93) years. The mean gestational age at presentation was 10.93 (±3.68) weeks. Seventy-five-point six (75.6%) percent of the cases presented in the first trimester. Fever, due to malaria and UTI, was the major risk factor for threatened miscarriage, occurring in 28.9% of the subjects. Fifty (55.6%) of the subjects progressed to the age of viability whereas 44.4% subjects miscarried prior to the age of viability. Forty-eight (96.0%) delivered at term whereas 2(4%) had preterm delivery at 34 and 35 weeks respectively. The main route of delivery was SVD (84%). The mean birth weight was 3.02 (±0.32) kg. There was no neonatal intensive care unit (NICU) admission. Conclusion: The incidence of threatened miscarriage (17.9%) in this study was high. Seventy-five point six (75.6%) of the cases occurred in the first trimester. Fifty-five point six (55.6%) progressed to the age of viability and the fetal outcome was favourable. Close follow up is imperative in maximizing a favourable outcome for cases of threatened miscarriage.