ABSTRACT
To assess pregnancy outcome in women with threatened miscarriage in the first trimester. To study various maternal complication and outcome of labor in pregnancy affected by first-trimester bleeding. Methods: This prospective study was carried out by institute from May 2013 to April 2014. 100 patients were included with a history of amenorrhea and urine pregnancy test positive with bleeding per vaginum in the first trimester. Results: In this case series, 100 cases of first-trimester bleeding were studied. Majority of patients were multigravida (66%). In the present study, 40 patient (40%) had a history of previous abortion out of these 16 (40%) had non-viable outcome and 24 (60%) continue with the pregnancy beyond 20 weeks. Majority of patients (68%) presented with spotting, among those 59 (86.7%) had a favorable outcome and only 9 (13.3%) out of 68 patients were aborted. All 10 patients of heavy bleeding category aborted. 5 out of 22 patients of bleeding of moderate category aborted. First-trimester bleeding associated with pain has a poor outcome. Conclusion: First-trimester bleeding is not only associated with miscarriage but also with a higher rate of pregnancy complications. First-trimester bleeding is associated with an increased risk of certain pregnancy-related complications namely placental abruption, preterm labor, delivery of low birth weight infants and preterm premature rupture of membrane.
ABSTRACT
The objective of the study is to earlier diagnose the cases of FGR (Fetal growth restriction) and to identify the possible causes and management option to prevent further damage and to study the fetomaternal outcome and improve fetomaternal outcome in FGR cases. Methods: This is an analytical study of 50 cases of FGR pregnancies done during the period of 1st April 2013 to 31st March 2014. Data was collected from the OPD books and indoor case papers of patients attending routine antenatal care and emergency services provided by obstetrics and gynaecology department of our institute. Results: 50 cases of FGR were studied. Various possible etiological factors were studied like presence of anaemia, hypoproteinemia and PIH, maternal pre-pregnancy weight, and average weight gain during pregnancy. Among them, malnutrition (64%) was the commonest aetiology of FGR followed by PIH (44%). Ante partum surveillance was done by serial fundal height measurement, maternal weight gain monitoring and serial ultrasound. 40% patients were having severe oligoamnios and 30% were having altered Doppler waveforms. Operative interference was required in 44% cases. 30 babies out of 50 were admitted to NICU. And perinatal mortality was 13.72%. Conclusion: Timely diagnosis, proper management at all levels in well-equipped centre can definitely prevent morbidity and mortality from FGR. Improving pre-pregnancy health, ensuring better antenatal care, effective use of contraception, preventing teenage pregnancies, stop smoking are some preventive measures.