Study of maternal and perinatal outcomes in pregnant women with first trimester vaginal bleeding in Telangana

Background: Vaginal bleeding in the first trimester can signal underlying placental dysfunction, which may later lead to unfavorable pregnancy outcomes. These outcomes include spontaneous abortion, miscarriage, ectopic pregnancy, and low birth weight. Method: A total of 90 pregnant women experiencing first-trimester vaginal bleeding were evaluated. Each participant underwent physical and obstetric examinations. Laboratory investigations included hemoglobin percentage (Hb%), clotting time (CT), bleeding time (BT), blood grouping (ABO and Rh), HIV, syphilis, HCV, fasting blood sugar (FBS), thyroid-stimulating hormone (TSH), and human chorionic gonadotropin (HCG). Urine analysis was performed for all patients. Ultrasound (USG) was used to assess gestational age, fetal cardiac activity, subchorionic hematoma size, presence of adnexal masses, and free fluid. Results: Among the participants, 22% experienced spotting, 74.4% had moderate bleeding, and 3.3% reported heavy bleeding. Regarding parity, 56.6% were nulliparous, 28% had one previous birth, 10% had two previous births, and 5.5% had more than two. A previous history of bleeding was noted in 34.4% of patients, and 14.4% had a history of abortion. Pregnancy complications included premature labor (24%), premature rupture of membranes (PROM) (6%), placental abruption (14%), intrauterine fetal death (3.3%), and intrauterine growth restriction (4%). Nearly half (48.8%) experienced no complications. Abortion occurred in 20% of cases, 10% underwent pregnancy termination, 38.8% had normal vaginal delivery, and 42.2% required cesarean section. Additionally, 12.2% of newborns had a low 5-minute APGAR score, and 16.6% required admission to the neonatal intensive care unit (NICU). Conclusion: First-trimester vaginal bleeding is an important indicator of potential maternal and fetal complications. Effective assessment and management by obstetricians and gynecologists are essential to reduce maternal morbidity and fetal mortality.