The effects of threatened abortions on pregnancy outcomes
Abstract
Objectives: The effects of first trimester threatened abortions on prenatal and postnatal pregnancy outcomes.
Material and methods: Data from 24.835 pregnant women were retrospectively analysed. The pregnant women were divided into two groups according to whether they had a first trimester threatened abortion or not. The demographic data and prenatal, postnatal and labour outcomes were compared for the two groups. Those cases with miscarriages during their follow-up, pregnant women with systemic diseases, multiple pregnancies and patients who were diagnosed with cervical erosion and cervical polypoid formation during vaginal bleeding examinations were all excluded.
Results: The age (p < 0.001), ART pregnancy rate (p = 0.03) and nulliparity rate (p = 0.013) in those with the risk of miscar- riage were statistically significantly higher than those without the risk. The gestational weeks (p < 0.001) and birth weights (p < 0.001) were significantly lower for the miscarriage group than in the control group. Hyperemesis gravidarum (p < 0.001), gestational diabetes mellitus (GDM) (p < 0.001) and placenta previa (p = 0.018) rates were statistically significantly and more frequent in the pregnancies with the threatened abortion group than in the control group. The rates of caesarean delivery were statistically significantly higher in the threatened abortion group (p < 0.001).
Conclusions: Threatened abortion between 6- and 14-weeks gestational age is a complication that may cause anxiety in the early weeks of pregnancy. But the treatment, follow-up and cause of threatened abortion all remain unclear.
Keywords: abortionpregnancy outcomestreatmentfirst trimester
References
- Woodward PJ, Kennedy A, Sohaey R. Diagnostic imaging: Obstetrics.
- Farrell T, Owen P. The significance of extrachorionic membrane separation in threatened miscarriage. BJOG: An International Journal of Obstetrics and Gynaecology. 1996; 103(9): 926–928.
- Chung T, Sahota DS, Lau TK, et al. Threatened Abortion: Prediction of Viability Based on Signs and Symptoms. The Australian and New Zealand Journal of Obstetrics and Gynaecology. 1999; 39(4): 443–447.
- Mouri MI, Rupp TJ. Threatened Abortion. StatPearls Publishing. 2018.
- Lykke JA, Dideriksen KL, Lidegaard O, et al. First-trimester vaginal bleeding and complications later in pregnancy. Obstet Gynecol. 2010; 115(5): 935–944.
- Schatz F, Guzeloglu-Kayisli O, Arlier S, et al. The role of decidual cells in uterine hemostasis, menstruation, inflammation, adverse pregnancy outcomes and abnormal uterine bleeding. Hum Reprod Update. 2016; 22(4): 497–515.
- Dadkhah F, Kashanian M, Eliasi G. A comparison between the pregnancy outcome in women both with or without threatened abortion. Early Hum Dev. 2010; 86(3): 193–196.
- Parrish L, Muglia L, DeFranco E. Bleeding during pregnancy is associated with familial preterm birth. The Journal of Maternal-Fetal & Neonatal Medicine. 2017; 32(1): 73–79.
- Ozdemirci S, Karahanoglu E, Esinler D, et al. Influence of threatened miscarriage on pregnancy and early postpartum period: a case–control report. The Journal of Maternal-Fetal & Neonatal Medicine. 2014; 28(10): 1186–1189.
- Das AG, Gopalan S, Dhahwal LK. Fetal Growth and Perinatal Outcome of Pregnancies Continuing After Threatened Abortion. The Australian and New Zealand Journal of Obstetrics and Gynaecology. 1996; 36(2): 135–139.
- Weiss J, Malone F, Vidaver J, et al. Threatened abortion: a risk factor for poor pregnancy outcome, a population-based screening study. American Journal of Obstetrics and Gynecology. 2004; 190(3): 745–750.
- American College of Obstetricians and Gynecologists, Task Force on Hypertension in Pregnancy. Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecologists’ Task Force on Hypertension in Pregnancy. Obstet Gynecol. 2013; 122(5): 1122–1131.
- American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2014; 37 Suppl 1: S81–S90.
- American Diabetes Association . Diagnosis and Classification of Diabetes Mellitus. Diabetes Care. 2012; 35(Supplement 1): S64–S71.
- Yakıştıran B, Yüce T, Söylemez F. First Trimester Bleeding and Pregnancy Outcomes: Case-Control Study. International Journal of Women's Health and Reproduction Sciences. 2015; 4(1): 4–7.
- De Sutter P, Bontinck J, Schutysers V, et al. First-trimester bleeding and pregnancy outcome in singletons after assisted reproduction. Hum Reprod. 2006; 21(7): 1907–1911.
- Özdemirci Ş, Demirdağ E, Kasapoğlu T, et al. Obstetric outcome of second trimester antenatal bleeding. J Matern Fetal Neonatal Med. 2016; 29(20): 3395–3399.
- Mulik V, Bethel J, Bhal K. A retrospective population-based study of primigravid women on the potential effect of threatened miscarriage on obstetric outcome. Journal of Obstetrics and Gynaecology. 2009; 24(3): 249–253.
- Saraswat L, Bhattacharya S, Maheshwari A, et al. Maternal and perinatal outcome in women with threatened miscarriage in the first trimester: a systematic review. BJOG. 2010; 117(3): 245–257.
- Bhattacharya S, Townend J, Shetty A, et al. Does miscarriage in an initial pregnancy lead to adverse obstetric and perinatal outcomes in the next continuing pregnancy? BJOG. 2008; 115(13): 1623–1629.
- Tayfur C, Burcu DC, Gulten O, et al. Association between platelet to lymphocyte ratio, plateletcrit and the presence and severity of hyperemesis gravidarum. J Obstet Gynaecol Res. 2017; 43(3): 498–504.
- Kurt R, Güler A, Silfeler D, et al. Relation of inflammatory markers with both presence and severity of hyperemesis gravidarum. Polish Gynaecology. 2014; 85(8).
- Evrenos AN, Cakir Gungor AN, Gulerman C, et al. Obstetric outcomes of patients with abortus imminens in the first trimester. Arch Gynecol Obstet. 2014; 289(3): 499–504.
- Wijesiriwardana A, Bhattacharya S, Shetty A, et al. Obstetric outcome in women with threatened miscarriage in the first trimester. Obstet Gynecol. 2006; 107(3): 557–562.
- Davari-Tanha F, Shariat M, Kaveh M, et al. Acta medica Iranica. 2008; 46(4).
