Fetomaternal Outcome Among Pregnant Women with First Trimester Vaginal Bleeding: A Study at Tertiary Care Centre

Background: Vaginal bleeding in the first trimester is one of the most common obstetric emergencies affecting 16–25% of pregnancies with an increased risk of adverse maternal and fetal outcomes. While the majority of cases of early bleeding proceed without complications, the potential for miscarriage, premature delivery, fetal growth restriction and neonatal morbidity are all concerns. This study was done to assess fetomaternal outcome in first trimester pregnant women with vaginal bleeding at a tertiary care center. Material and Methods: The study is a prospective observational study which was conducted in the department of obstetrics and gynaecology in Government R.D.B.P. Jaipuria hospital, Jaipur during a period of about 10.5 months. 300 women with singleton pregnancy were enrolled after informed consent in the first trimester of pregnancy with vaginal bleeding. A pre-designed proforma was used to obtain detailed demographic, clinical, laboratory and ultrasonographic data. Participants were followed until pregnancy outcome to assess maternal and fetal outcomes. The data were analysed by SPSS version 26.0 and p value less than 0.05 was taken as statistically significant. Results: Most of women were in the age group of 21-25 years (42.0 %), Primigravida (61.0 %) and presented at 6-10 weeks of gestation (54.0 %). The most frequent diagnosis was threatened abortion (56.0%). Overall, the proportion of women who had term delivery was 61.0%, abortion was 28.0% and preterm delivery was 8.0%. The most common maternal complication was preterm labour (8.0%). Of the 207 live births, 88.4% were at term, 75.4% had a birth weight >2.5 kg, 90.3% and 95.2% had an APGAR score of 7–10 at 1 and 5 minutes respectively. Intrauterine growth restriction was present in 23.2% of neonates, while 12.6% needed admission to NICU, mostly for birth asphyxia and respiratory distress syndrome. Conclusion: Vaginal bleeding in the first trimester of pregnancy is a significant risk factor for poor pregnancy outcomes and should be assessed early, risk-stratified and monitored closely during the antenatal period. While most pregnancies resulted in term delivery, women with early pregnancy bleeding were still at risk for miscarriage, preterm delivery, intrauterine growth restriction and neonatal morbidity. Fetomaternal outcomes may be better with early ultrasonographic assessment and individualized obstetric management.

Keywords: First trimester bleeding; Threatened abortion; Fetomaternal outcome; Pregnancy outcome; Neonatal outcome.