A Survey on the Causes, Treatment Method and Pregnancy Outcomes in Women with Abnormal First Trimester Bleeding

Document Type : Original Article


1 Associate Professor, Department of Obstetrics and Gynecology, Uterine Abnormal Bleeding Research Center, School of Medicine, Semnan University of Medical Sciences, Semnan, Iran.

2 BC in Nursing, Department of Obstetrics, Uterine Abnormal Bleeding Research Center, School of Medicine, Semnan University of Medical Sciences, Semnan, Iran.


Introduction: More than 25% of pregnant women have bleeding at first trimester and first of second trimester that half of them will experience miscarriage. There are different causes and methods for diagnosis and treatment of bleeding during pregnancy. Regarding to relatively high prevalence of first trimester bleeding and recommended diagnostic and treatment methods, this study was performed with aim to evaluate the causes, diagnostic and treatment methods and pregnancy outcomes in patients admitted in the department of obstetrics, Semnan Amiralmomenin hospital.
Methods: This cross-sectional and prospective study was performed on 200 patients with first trimester bleeding admitted in the department of obstetrics, Semnan Amiralmomenin hospital during 2013-2014. Information of patients with approved pregnancy including the causes of bleeding, diagnostic and treatment methods and pregnancy outcome were studied and recorded in researcher-made questionnaire. Data was analyzed by SPSS software (version 16) and descriptive statistical methods. P<0.05 was considered significant.
Results: Causes of abnormal bleeding were blighted ovum in 2 cases (1%), incomplete abortion in 52 (26%), missed abortion in 62 (31%), complete abortion in 24 (12%), threatened abortion in 54 (27%), ectopic pregnancy in 2 (1%), molar pregnancy in 1 (0.5%) and cervical polyps in 1 (0.5%). Treatment method was medical and surgery in 56 cases (48.27%), medical in 40 (34.48%) and surgical in 20 (17.24%). Among 54 (31%) of threatened abortion, 20 (37.05%) had abortion, 10 (18.5%) preterm delivery, and 22 (47.4%) term delivery. All cases had gestational age <9 weeks and abortion was happened in 70% of cases with previous abortion.
Conclusion: The causes of abnormal uterine bleeding which led to admission at first trimester of pregnancy were inevitable abortion, threatened abortion, ectopic pregnancy, molar pregnancy and cervical polyp, respectively. The most common causes of admission were inevitable abortion and the most common treatment methods were medical + surgery. About half of the threatened abortion cases resulted in term delivery, 37 % abortion and 18% preterm delivery. Gestational age <9 weeks and previous abortion were associated with more bleeding and abortion.


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