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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Main Authors: C. Chollet, B. Andre, M. Voglimacci, A. Ghassani, O. Parant, P. Guerby
Format: Article
Language:English
Published: IMR Press 2020-02-01
Series:Clinical and Experimental Obstetrics & Gynecology
Subjects:
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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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
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AT aghassani perinataloutcomesofsecondtrimesterantenatalgenitalbleeding
AT oparant perinataloutcomesofsecondtrimesterantenatalgenitalbleeding
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