Naila Bangash, Humaira Ahmed.
Evaluation of cases reporting with bleeding per vagina during first 20 weeks of gestation.
Pak Armed Forces Med J Jan ;55(3):219-23.

A descriptive study was carried out to determine prevalence of vaginal bleeding in pregnancy till 20 weeks of gestation to find out the causes and management of such cases. Out of the total 13200 pregnant patients admitted in the gynecology ward from January 1999 to December 2000, 1494 patients (11.3%) presented with bleeding in early pregnancy. The prevalence of bleeding before 20 weeks was calculated to be 11.3%. Amongst these cases, 1434 (95.9%) were abortions, 28 (1.87%) ectopic, 22 (1.47%) molar and 10 (0.66%) were due to local causes and trauma. The highest frequency of bleeding was in the first trimester, 81.7% as compared to 18.2% in the second trimester. The prevalence of abortion was 10.8% in this period. Women between 26-35 years of age experienced more abortions. The percentage of abortion increased as the parity increased. 42.5% and 30.3% abortions in fourth and fifth pregnancies respectively. The previous history of abortion 632 (44%) and the last pregnancy abortion 591 (41.2%) were the significant factors in the past obstetric performance of the patients. The main maternal risk factors were medical problems in 307 cases (21.4%), treatment for infertility in 265 cases (18.47%) and use of contraception in 266 patients (18.5%). No cause was found in 200(13.9%) patients. The bleeding was conservatively managed in 345 cases and the pregnancy progressed in 108 patients. 101 women underwent dilatation and curettage for missed abortion and 695 evacuation and curettage for incomplete abortion. Laparotomy for ectopic was done in 28 females and suction curettage was carried out for molar pregnancy in 22 patients.

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