Indentification of the causes of first trimester vaginal bleeding and fetomaternal outcomes in cases with threatened abortion

A pregnancy may end in a live birth, a spontaneous miscarriage (spontaneous abortion), an induced abortion, or a stillbirth. Approximately one-fourth of women will have first-trimester bleeding, and about half of those women will have a spontaneous abortion and approximately 50% will continue with a normally progressing pregnancy. First-trimester bleeding leads to pregnancy loss in over 50% of cases. To identify the various causes of first trimester vaginal bleeding. To determine maternal and fetal outcomes in patients with threatened abortion. : This prospective observational study was carried out on the pregnant females who present to our tertiary care hospital with first trimester vaginal bleeding over a time period of 15 months (January 2023-March 2024) and met the inclusion criteria. Total of 133 females were enrolled in the study out of which 31 lost to follow up. Data of 102 females was collected and results were compiled. Patients of threatened abortion were followed up for maternal and perinatal outcomes. : Majority 41(40.20%) of the cases in the study were of 26 -30 years age group with mean gestational age of 9.52+/- 2.76 weeks. 51.96% cases were threatened abortion followed by 18.62% cases missed abortion, 13.72% cases incomplete abortion, 7.85% ectopic pregnancy, 3.92% complete abortion, 2.51% inevitable abortion and one (0.98%) case of molar pregnancy. Cases of threatened abortion were followed for outcome and preterm labour was seen in 49% cases, PROM in 35.8%, placenta previa in 20.7%, abruptio placenta in 13.2%, PIH in 11.3%, IUFD in 7.574%, second trimester complete abortion in 6.7% and PPH in 3.8%. Out of total 46 live babies 27(58.69%) had low birth weight. 31(67.39%) had APGAR score above seven at 1 min while 15 cases (32.61%) had below seven and also required NICU admission. : Patients presenting with first trimester bleeding should be categorized as high risk patients and be monitored actively during antenatal period with appropriate management strategies in place. In light of various research findings, it is evident that there is merit in conducting further investigations to identify the most reliable predictors of adverse pregnancy outcome in women experiencing first trimester vaginal bleeding.