Study of outcome of pregnancy in patients with first-trimester bleeding per vaginum.

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.

Bilateral Facial Lipoatrophy-As Sole Manifestation of Lupus Panniculitis.

Lupus erythematosus can have varied manifestation in skin ranging from classical lesion of DLE (Discoid Lupus Erythematosus) and photosensitivity to Necrotic lesions of vasculitis or atrophic lesion. Panniculitis as histological finding in biopsy taken from any lesion of SLE (Systemic Lupus Erythematosus) is expected as associated finding. We report one case with lipoatrophy as sole manifestation of lupus panniculitis in which patient presented to us with bilateral facial lipoatrophy. On further investigation patient was ANA (Antinuclear Antibody) positive and histopathology was also suggestive of lupus panniculitis. LE (Lupus Erythematous) presenting solely as lupus panniculitis is rare clinical manifestation and poses a considerable diagnostic challenge more so when presentation is lipoatropy.