Publication: Outcome of Pregnancy Complicated by Threatened Abortion
Date
2011
Journal Title
Journal ISSN
Volume Title
Publisher
Kathmandu University
Abstract
ABSTRACT
Background
Threatened abortion is the most common complication in the first half of
pregnancy. Most of these pregnancies continue to term with or without treatment.
Spontaneous abortion occurs in less than 30% of these women. Threatened
abortion had been shown to be associated with increased incidence of antepartum
haemorrhage, preterm labour and intra uterine growth retardation.
Objective
This study was to asses the outcome of threatened abortion following treatment.
Methods
This prospective study was carried out in Dhulikhel Hospital - Kathmandu University
Hospital from January 2009 till May 2010. Total 70 cases of threatened abortion
were selected, managed with complete bed rest till 48 hrs of cessation of bleeding,
folic acid supplementation, uterine sedative, and hormonal treatment till 28
weeks of gestation. Ultrasonogram was performed for diagnosis and to detect the
presence of subchorionic hematoma. Patients were followed up until spontaneous
abortion or up to delivery of the fetus. The measures used for the analysis
were maternal age, parity, gestational age at the time of presentation, previous
abortions, presence of subchorionic hematoma, complete abortion, continuation
of pregnancy, antepartum hemorrhage, intrauterine growth retardation and
intrauterine death of fetus.
Results
Out of 70 cases subchorionic haematoma was found in 30 (42.9%) cases. There
were 12 (17.1%) patients who spontaneously aborted after diagnosis of threatened
abortion during hospital stay, 5 (7.1%) aborted on subsequent visits while 53
(75.8%) continued pregnancy till term. Among those who continued pregnancy
intrauterine growth retardation was seen in 7 (13.2%), antepartum hemorrhage in 4
(7.5%), preterm premature rupture of membrane in 3 (5.66%) and IUD in 3 (5.66%).
Spontaneous abortion was found more in cases with subchorionic hematoma of
size more than 20 cm2.
Conclusion
In cases of threatened abortion with or without the presence of subchorionic
hematoma, prognostic outcome is better following treatment with bed rest, uterine
sedatives, folic acid supplementation and hormonal treatment.
KEY WORDS
abortion, pregnancy outcome, subchorionic hematoma, threatened abortion.
Description
Dongol A, Mool S, Tiwari P
Department of Gynaecology and Obstretrics Dhulikhel Hospital - Kathamndu University Hospital Dhulikhel Hospital, Kavre, Nepal