IMR Press / CEOG / Volume 47 / Issue 1 / DOI: 10.31083/j.ceog.2020.01.5112
Open Access Original Research
Perinatal outcomes of second trimester antenatal genital bleeding
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1 CHU Toulouse, Pôle de Gynécologie Obstétrique, Hôpital Paule de Viguier, Toulouse, France
2 Université de Toulouse III, UMR1027, Toulouse, France
3 INSERM, UMR1027, Toulouse, France
Clin. Exp. Obstet. Gynecol. 2020 , 47(1), 105–110; https://doi.org/10.31083/j.ceog.2020.01.5112
Published: 15 February 2020
Abstract

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.

Keywords
Vaginal bleeding
Ultrasound
Second trimester of pregnancy
Adverse pregnancy outcomes
Preterm delivery
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