Perinatal outcomes of second trimester antenatal genital bleeding
Objective: To evaluate the prognosis of singleton pregnancies complicated by genital bleeding during the 2nd trimester and to identify the factors associated with poor perinatal outcome. Materials and Methods: We conducted a retrospective study (January 2009 to December 2012), which included all wom...
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Language: | English |
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IMR Press
2020-02-01
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Series: | Clinical and Experimental Obstetrics & Gynecology |
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Online Access: | https://www.imrpress.com/journal/CEOG/47/1/10.31083/j.ceog.2020.01.5112 |
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author | C. Chollet B. Andre M. Voglimacci A. Ghassani O. Parant P. Guerby |
author_facet | C. Chollet B. Andre M. Voglimacci A. Ghassani O. Parant P. Guerby |
author_sort | C. Chollet |
collection | DOAJ |
description | Objective: To evaluate the prognosis of singleton pregnancies complicated by genital bleeding during the 2nd trimester and to identify the factors associated with poor perinatal outcome. Materials and Methods: We conducted a retrospective study (January 2009 to December 2012), which included all women presenting with midtrimester bleeding (15 to 27 weeks of gestation). The cases were compared with women without bleeding, who delivered in our center during the same period. Results: Ninety-seven women were included (0.57% of the overall singleton births). An underlying placental cause was discovered by ultrasound in 56% of the cases (low-lying placenta, partially detached placenta or a combination of both of these pathologies). We report a significantly increased rate of preterm birth (47.4% vs. 12.2%; RR=3.9), perinatal mortality (11.3% vs. 1.3%; RR=8.8), PPROM (16.5% vs. 3.7%; RR=4.5; CI 95% [2.8-7.1]), and cesarean section (42.3% vs. 21%; RR=2; CI 95% [1.6-2.5]) in the bleeding group. The factors associated with preterm birth were recurrent bleeding (OR=4.7), gestational age > 22 WG at the first bleeding (OR=3.7), and low-lying placenta. Conclusion: Despite a low incidence, the occurrence of bleeding in the 2nd trimester of pregnancy should alert the physician because of increased perinatal morbimortality. These patients may thus require increased monitoring. |
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institution | Directory Open Access Journal |
issn | 0390-6663 |
language | English |
last_indexed | 2024-04-14T04:52:57Z |
publishDate | 2020-02-01 |
publisher | IMR Press |
record_format | Article |
series | Clinical and Experimental Obstetrics & Gynecology |
spelling | doaj.art-64ea383280d948eb8fca9c053d7a754b2022-12-22T02:11:13ZengIMR PressClinical and Experimental Obstetrics & Gynecology0390-66632020-02-0147110511010.31083/j.ceog.2020.01.5112S0390-6663(20)00213-4Perinatal outcomes of second trimester antenatal genital bleedingC. Chollet0B. Andre1M. Voglimacci2A. Ghassani3O. Parant4P. Guerby5CHU Toulouse, Pôle de Gynécologie Obstétrique, Hôpital Paule de Viguier, Toulouse, FranceCHU Toulouse, Pôle de Gynécologie Obstétrique, Hôpital Paule de Viguier, Toulouse, FranceCHU Toulouse, Pôle de Gynécologie Obstétrique, Hôpital Paule de Viguier, Toulouse, FranceCHU Toulouse, Pôle de Gynécologie Obstétrique, Hôpital Paule de Viguier, Toulouse, FranceCHU Toulouse, Pôle de Gynécologie Obstétrique, Hôpital Paule de Viguier, Toulouse, FranceCHU Toulouse, Pôle de Gynécologie Obstétrique, Hôpital Paule de Viguier, Toulouse, FranceObjective: To evaluate the prognosis of singleton pregnancies complicated by genital bleeding during the 2nd trimester and to identify the factors associated with poor perinatal outcome. Materials and Methods: We conducted a retrospective study (January 2009 to December 2012), which included all women presenting with midtrimester bleeding (15 to 27 weeks of gestation). The cases were compared with women without bleeding, who delivered in our center during the same period. Results: Ninety-seven women were included (0.57% of the overall singleton births). An underlying placental cause was discovered by ultrasound in 56% of the cases (low-lying placenta, partially detached placenta or a combination of both of these pathologies). We report a significantly increased rate of preterm birth (47.4% vs. 12.2%; RR=3.9), perinatal mortality (11.3% vs. 1.3%; RR=8.8), PPROM (16.5% vs. 3.7%; RR=4.5; CI 95% [2.8-7.1]), and cesarean section (42.3% vs. 21%; RR=2; CI 95% [1.6-2.5]) in the bleeding group. The factors associated with preterm birth were recurrent bleeding (OR=4.7), gestational age > 22 WG at the first bleeding (OR=3.7), and low-lying placenta. Conclusion: Despite a low incidence, the occurrence of bleeding in the 2nd trimester of pregnancy should alert the physician because of increased perinatal morbimortality. These patients may thus require increased monitoring.https://www.imrpress.com/journal/CEOG/47/1/10.31083/j.ceog.2020.01.5112vaginal bleedingultrasoundsecond trimester of pregnancyadverse pregnancy outcomespreterm delivery |
spellingShingle | C. Chollet B. Andre M. Voglimacci A. Ghassani O. Parant P. Guerby Perinatal outcomes of second trimester antenatal genital bleeding Clinical and Experimental Obstetrics & Gynecology vaginal bleeding ultrasound second trimester of pregnancy adverse pregnancy outcomes preterm delivery |
title | Perinatal outcomes of second trimester antenatal genital bleeding |
title_full | Perinatal outcomes of second trimester antenatal genital bleeding |
title_fullStr | Perinatal outcomes of second trimester antenatal genital bleeding |
title_full_unstemmed | Perinatal outcomes of second trimester antenatal genital bleeding |
title_short | Perinatal outcomes of second trimester antenatal genital bleeding |
title_sort | perinatal outcomes of second trimester antenatal genital bleeding |
topic | vaginal bleeding ultrasound second trimester of pregnancy adverse pregnancy outcomes preterm delivery |
url | https://www.imrpress.com/journal/CEOG/47/1/10.31083/j.ceog.2020.01.5112 |
work_keys_str_mv | AT cchollet perinataloutcomesofsecondtrimesterantenatalgenitalbleeding AT bandre perinataloutcomesofsecondtrimesterantenatalgenitalbleeding AT mvoglimacci perinataloutcomesofsecondtrimesterantenatalgenitalbleeding AT aghassani perinataloutcomesofsecondtrimesterantenatalgenitalbleeding AT oparant perinataloutcomesofsecondtrimesterantenatalgenitalbleeding AT pguerby perinataloutcomesofsecondtrimesterantenatalgenitalbleeding |