Evaluation of Perinatal Results of Pregnant Women Diagnosed with Abortus Imminence in the First Trimester

Abstract

Objective: The aim of this study is to evaluate the perinatal outcomes of pregnant women diagnosed with abortus imminens in the first trimester. Materials and Methods: The study group consisted of 100 patients diagnosed with abortion imminens and the control group of 100 patients who applied to our hospital's gynecology and obstetrics clinic between January 2019 and July 2019.Fetal and maternal perinatal outcomes were recorded by monitoring the age, parity, number of gravida, demographic characteristics and prognosis of pregnant women. The comparison of the groups was done by Student t test in normal distributed data, Mann Whitney test in normal non-distributed numerical data, and chi-square test in categorical data. P <0.05 was considered statistically significant. Results: When the pregnant women were examined in terms of birth parameters, there was no difference between groups in terms of delivery type and maternal birth complications (p = 1,000 and p = 0.276). However, the incidence of premature rupture of membranes (PROM) were higher in the group diagnosed with abortion and the difference between the groups was statistically significant (p <0.001). There was no difference between the groups in terms of abortion and abortion history, alcohol use, presence of comorbidity, and social security (p> 0.05) Conclusion: Abortus imminens cases are associated with poor obstetric outcomes. The incidence of premature rupture of membranes have increased in the prognosis of abortus imminens cases.

Keywords

• Abortus imminens
• perinatal outcomes
• premature rupture of membranes

Birinci Trimesterde Abortus İmminens Tanısı Konulan Gebelerin Perinatal Sonuçlarının Değerlendirilmesi

Öz

Amaç: Birinci trimesterde abortus imminens tanısı alan gebelerin prognozlarını takip ederek perinatal sonuçlarının değerlendirilmesidir. Materyal ve Metot Çalışmaya Ocak 2019 ile Temmuz 2019 arası zaman diliminde hastanemiz kadın hastalıkları ve doğum kliniğine başvuran abortus imminens tanısı alan 100 hasta çalışma grubunu, diğer 100 kişilik grup kontrol grubunu oluşturdu. Çalışmaya katılan gebelerin yaş, parite, gravida sayıları, demografik özellikleri, prognozları takip edilerek oluşan fetal ve maternal perinatal sonuçları kayıt altına alındı. Grupların kıyaslanması normal dağılan numerik verilerde Student t testi, normal dağılmayan numerik verilerde Mann Whitney testi, kategorik verilerde ki-kare testi ile yapıldı. Bulgular: Gebeler doğum parametreleri açısından incelendiğinde doğum şekli ve maternal doğum komplikasyonları açısından gruplar arasında fark olmadığı görüldü (p=1,000 ve p=0,276). Prematür membran rüptürü (PROM) görülme sıklığı abortus imminens tanısı alan grupta daha fazladır ve gruplar arasındaki fark istatistiksel olarak anlamlıdır (p<0,001). Düşük ve kürtaj öyküsü, alkol kullanımı, ek hastalık varlığı, sosyal güvence varlığı açısından da gruplar arasında fark gözlenmedi (p>0,05). Sonuç: Abortus imminens vakaları kötü obstetrik sonuçlarla ilişkilidir. Abortus imminens vakalarının prognozunda prematür

Anahtar Kelimeler

• Abortus imminens
• Perinatal sonuçlar
• prematür membran rüptürü

References

1. Wijesiriwardana A, Bhattacharya S, Shetty A, Smith N. Obstetric outcome in women with threatened miscarriage in the first trimester. Obstet Gynecol. 2006;107:557-562. doi:10.1097/01.AOG.0000199952.82151.de
2. Sotiriadis A, Papatheodorou S, Makrydimas G. Threatened miscarriage evaluation and management. BMJ. 2004;329:152-155. doi: https://doi.org/10.1136/bmj.329.7458.152
3. Johns J, Jauniaux E. Threatened miscarriage as a predictor of obstetric. Obstet Gynecol. 2006;107:845-850. doi: 10.1097/01.AOG.0000206186.91335.9a
4. Haas DM, Hathaway TJ, Ramsey PS. Progestogen for preventing miscarriage (Review). Cochrane Database Syst Rev. 2013;10:CD003511. doi: 10.1002/14651858.CD003511.pub3
5. Wang JX, Norman RJ, Wilcox AJ. Incidence of spontaneous abortion among pregnancies produced by assisted reproductive technology. Hum Reprod. 2004;19:272-277. doi:10.1093/humrep/deh078
6. Wilcox AJ , Weiberg CR , O'Connor JF, ve ark. Incidence of early loss of pregnancy. N Engl J Med 1988;319-189. doi: 10.1056 / nejm198807283190401
7. Basama FM, Crosfill F. The outcome of pregnancies in 182 women with threatened miscarriage. Arch Gynecol Obstet. 2004;270:86–90. doi: https://doi.org/10.1007/s00404-003-0475-z
8. Dadkhah F, Kashanian M, Eliasi G. A comparison between the pregnancy outcome in women with or without threatened abortion. Early Human Dev. 2010;86:193-196. doi: https://doi.org/10.1016/j.earlhumdev.2010.02.005

9. Obed JY, Adewole IF. Antepartum hemorrhage: the influence of first trimester uterine bleeding. West Afr J Med. 1997;16:24-26 PMID:9133819.
10. Davari-Tanha F, Shariat M, Kaveh M, Ebrahimi M, Jalalvand S. Threatened abortion: A risk factor for poor pregnancy outcome. Acta Med İran. 2008;46:314-320.
11. Johns J, Hyett J, Jauniaux E. Obstetric outcome after threatened miscarriage with and without a hematoma on ultrasound. Obstet Gynecol.2003;102:483-487. doi: https://doi.org/10.1016/S0029-7844(03)00580-5
12. Mulik V, Bethel J, Bhal K. A retrospective populationbased study of primigravid women on the potential effect of threatened miscarriage on obstetric outcome. J Obstet Gynaecol. 2004;24:249-253. doi: https://doi.org/10.1080/01443610410001660724
13. Sipila P, Hartikainen Sorri AL, Oja H, Von WL. Perinatal outcome of pregnancies complicated by vaginal bleeding. Br J Obtstet Gynaecol. 1992;99:959-963. doi: https://doi.org/10.1111/j.1471-0528.1992.tb13697.x
14. Tongsong T, Srisomboon J, Wanapirak C, Sirichotiyakul S, Pongsatha S, Polsrisuthikul T. Pregnancy outcome of threatened abortion with demonstrable fetal cardiac activity: A cohort study. J Obstet Gynaecol. 1995;21:331-335. doi: https://doi.org/10.1111/j.1447-0756.1995.tb01019.x
15. Evrenos AN, Gungor AN, Gulerman C, Cosar E. Obstetric outcomes of patients with abortus imminens in the first trimester. Arch Gynaecol Obstet. 2014;289(3):499-504. doi: 10.1007/s00404-013-2979-5