The fate of pregnancy after first and middle trimester bleeding
Kessler, I.; Lancet, M.; Schwartz, Z.; Yemini, M.; Kassner, R.
Harefuah 110(1): 8-11
1986
ISSN/ISBN: 0017-7768 PMID: 3957145 Document Number: 267485
The results of the pregnancies of 82 women who had bled during weeks 14-28 (Group A) and 106 who had first trimester hemorrhage (Group B) were compared. Group A patients had to be hospitalized more often and for longer periods. Abortion ensued in 23.1% in group A, and 16.0% in group B, while term deliveries occurred in 59.8 and 70.7%, respectively. Prematurity was twice as frequent as usual in patients who bled during pregnancy. The cesarean rate was high in group A (19%) but only 6.7% in group B (p < 0.01). The latter was similar to the rate of cesareans in the general population at the time of the study. All babies were live-born, but the postpartum mortality was three times higher in the study groups than in the general population. The causes of death were extremely prematurity and malformations. The rate of malformations was double that in patients who did not bleed and was similar in both groups. The prognosis of pregnancy after middle trimester bleeding is worse than after hemorrhage in the first trimester (though the difference is not significant statistically) and definitely worse in both groups than in women who do not bleed during pregnancy. Hemorrhage in pregnancy, whenever it occurs, and however brief it may be, indicates a high-risk pregnancy.