Second-trimester vaginal bleeding: Correlation of ultrasonographic findings with perinatal outcome
Objective: Our purpose was to determine the relationship between ultrasonographic findings and perinatal outcome in patients with second-trimester vaginal bleeding. Study Design: A retrospective case-control study was performed. One hundred sixty-seven patients with ultrasonographic examinations per...
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| Veröffentlicht in: | American journal of obstetrics and gynecology 1998-02, Vol.178 (2), p.336-340 |
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| description | Objective: Our purpose was to determine the relationship between ultrasonographic findings and perinatal outcome in patients with second-trimester vaginal bleeding.
Study Design: A retrospective case-control study was performed. One hundred sixty-seven patients with ultrasonographic examinations performed for bleeding between 13 and 26 weeks' gestation were identified through a comprehensive ultrasonography database. The main ultrasonographic findings of interest were the presence of an intrauterine clot, membrane separation, and placenta previa. A control group of 167 patients was obtained by selecting the next consecutive patient from the comprehensive perinatal database. Perinatal outcome measures for both groups were recorded.
Results: Multiparity was more common in patients with bleeding than in controls (69% vs 58%,
p=0.036), as was history of two or more previous preterm deliveries (6% vs none,
p=0.005). Second-trimester vaginal bleeding was associated with increased risk of preterm delivery (relative risk 1.9, 95% confidence interval 1.4 to 2.8), fetal death (relative risk 6.3, 95% confidence interval 1.9 to 2.1), and perinatal death (relative risk 5.4, 95% confidence interval 2.1 to 13.7). The perinatal mortality rate was 162:1000 in these patients versus 30:1000 in controls. To assess the impact of ultrasonographic abnormalities, the study group was divided into two groups. Among the patients with second-trimester vaginal bleeding those with abnormal ultrasonographic findings had an increased risk of preterm delivery (relative risk 2.0, 95% confidence interval 1.4 to 2.8), fetal death (relative risk 2.6, 95% confidence interval 1.1 to 6.3), perinatal death (relative risk 2.6, 95% confidence interval 1.3 to 5.3), and neonatal intensive care unit admissions (relative risk 3.2, 95% confidence interval 1.6 to 6.1). The perinatal mortality rate was 258:1000 for patients with abnormal ultrasonographic examinations.
Conclusion: Second-trimester vaginal bleeding is more common in multiparous women and in women with a history of a previous preterm delivery. Perinatal morbidity and mortality is increased in patients with bleeding during the second trimester. The risk is compounded when abnormalities are detected by ultrasonography. |
| doi_str_mv | 10.1016/S0002-9378(98)80022-7 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_79727190</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0002937898800227</els_id><sourcerecordid>79727190</sourcerecordid><originalsourceid>FETCH-LOGICAL-c421t-82f3863b04a69ce17eadda71c68b70ff8efd281cbc6a8d84856dee023ae888ed3</originalsourceid><addsrcrecordid>eNqFkU9PGzEQxa2qiKa0HwFpD6gth6W2d-M_XFAVlYKE1APt2fLa42C0sVPbS8W3r5dEOZbTaDS_N2O_h9ApwRcEE_b1HmNMW9lx8UWKc1Eb2vI3aEGw5C0TTLxFiwPyDr3P-XFuqaTH6FguMe4lW6DhHkwMti3JbyAXSM2TXvugx2YYAawP68tmFVOCURcfQxNdM40l6RxDXCe9ffCmcT7MYG7--vLQbCFVfakb4lRM3MAHdOT0mOHjvp6g39fff61u2rufP25X3-5a01NSWkFdJ1g34F4zaYBw0NZqTgwTA8fOCXCWCmIGw7SwohdLZgEw7TQIIcB2J-jTbu82xT9T_Yza-GxgHHWAOGXFJaecSFzBz_8HWY97zPFMLnekSTHnBE5tq086PSuC1ZyCeklBzRYrKdRLCopX3en-wjRswB5Ue9vr_Gw_19no0SUdjM8HjBLe0eWMXe0wqLY9eUgqGw_B1FwSmKJs9K885B-oiKX7</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>764040700</pqid></control><display><type>article</type><title>Second-trimester vaginal bleeding: Correlation of ultrasonographic findings with perinatal outcome</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals Complete</source><creator>Signore, Caroline C. ; Sood, Anil K. ; Richards, Douglas S.</creator><creatorcontrib>Signore, Caroline C. ; Sood, Anil K. ; Richards, Douglas S.</creatorcontrib><description>Objective: Our purpose was to determine the relationship between ultrasonographic findings and perinatal outcome in patients with second-trimester vaginal bleeding.
Study Design: A retrospective case-control study was performed. One hundred sixty-seven patients with ultrasonographic examinations performed for bleeding between 13 and 26 weeks' gestation were identified through a comprehensive ultrasonography database. The main ultrasonographic findings of interest were the presence of an intrauterine clot, membrane separation, and placenta previa. A control group of 167 patients was obtained by selecting the next consecutive patient from the comprehensive perinatal database. Perinatal outcome measures for both groups were recorded.
Results: Multiparity was more common in patients with bleeding than in controls (69% vs 58%,
p=0.036), as was history of two or more previous preterm deliveries (6% vs none,
p=0.005). Second-trimester vaginal bleeding was associated with increased risk of preterm delivery (relative risk 1.9, 95% confidence interval 1.4 to 2.8), fetal death (relative risk 6.3, 95% confidence interval 1.9 to 2.1), and perinatal death (relative risk 5.4, 95% confidence interval 2.1 to 13.7). The perinatal mortality rate was 162:1000 in these patients versus 30:1000 in controls. To assess the impact of ultrasonographic abnormalities, the study group was divided into two groups. Among the patients with second-trimester vaginal bleeding those with abnormal ultrasonographic findings had an increased risk of preterm delivery (relative risk 2.0, 95% confidence interval 1.4 to 2.8), fetal death (relative risk 2.6, 95% confidence interval 1.1 to 6.3), perinatal death (relative risk 2.6, 95% confidence interval 1.3 to 5.3), and neonatal intensive care unit admissions (relative risk 3.2, 95% confidence interval 1.6 to 6.1). The perinatal mortality rate was 258:1000 for patients with abnormal ultrasonographic examinations.
Conclusion: Second-trimester vaginal bleeding is more common in multiparous women and in women with a history of a previous preterm delivery. Perinatal morbidity and mortality is increased in patients with bleeding during the second trimester. The risk is compounded when abnormalities are detected by ultrasonography.</description><identifier>ISSN: 0002-9378</identifier><identifier>EISSN: 1097-6868</identifier><identifier>DOI: 10.1016/S0002-9378(98)80022-7</identifier><identifier>PMID: 9500496</identifier><identifier>CODEN: AJOGAH</identifier><language>eng</language><publisher>Philadelphia, PA: Mosby, Inc</publisher><subject>Adult ; Biological and medical sciences ; Case-Control Studies ; Diseases of mother, fetus and pregnancy ; Female ; Fetal Death - epidemiology ; Gynecology. Andrology. Obstetrics ; high-risk pregnancy ; Humans ; Intensive Care, Neonatal ; Medical sciences ; Obstetric Labor, Premature - epidemiology ; Parity ; Placenta Previa - complications ; Pregnancy ; Pregnancy Complications, Cardiovascular - diagnostic imaging ; Pregnancy Outcome ; Pregnancy Trimester, Second ; Pregnancy. Fetus. Placenta ; Retrospective Studies ; Risk Factors ; Second-trimester bleeding ; Ultrasonography ; ultrasonography in pregnancy ; Uterine Hemorrhage - diagnostic imaging</subject><ispartof>American journal of obstetrics and gynecology, 1998-02, Vol.178 (2), p.336-340</ispartof><rights>1998 Mosby, Inc.</rights><rights>1998 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c421t-82f3863b04a69ce17eadda71c68b70ff8efd281cbc6a8d84856dee023ae888ed3</citedby><cites>FETCH-LOGICAL-c421t-82f3863b04a69ce17eadda71c68b70ff8efd281cbc6a8d84856dee023ae888ed3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/S0002-9378(98)80022-7$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=2173256$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/9500496$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Signore, Caroline C.</creatorcontrib><creatorcontrib>Sood, Anil K.</creatorcontrib><creatorcontrib>Richards, Douglas S.</creatorcontrib><title>Second-trimester vaginal bleeding: Correlation of ultrasonographic findings with perinatal outcome</title><title>American journal of obstetrics and gynecology</title><addtitle>Am J Obstet Gynecol</addtitle><description>Objective: Our purpose was to determine the relationship between ultrasonographic findings and perinatal outcome in patients with second-trimester vaginal bleeding.
Study Design: A retrospective case-control study was performed. One hundred sixty-seven patients with ultrasonographic examinations performed for bleeding between 13 and 26 weeks' gestation were identified through a comprehensive ultrasonography database. The main ultrasonographic findings of interest were the presence of an intrauterine clot, membrane separation, and placenta previa. A control group of 167 patients was obtained by selecting the next consecutive patient from the comprehensive perinatal database. Perinatal outcome measures for both groups were recorded.
Results: Multiparity was more common in patients with bleeding than in controls (69% vs 58%,
p=0.036), as was history of two or more previous preterm deliveries (6% vs none,
p=0.005). Second-trimester vaginal bleeding was associated with increased risk of preterm delivery (relative risk 1.9, 95% confidence interval 1.4 to 2.8), fetal death (relative risk 6.3, 95% confidence interval 1.9 to 2.1), and perinatal death (relative risk 5.4, 95% confidence interval 2.1 to 13.7). The perinatal mortality rate was 162:1000 in these patients versus 30:1000 in controls. To assess the impact of ultrasonographic abnormalities, the study group was divided into two groups. Among the patients with second-trimester vaginal bleeding those with abnormal ultrasonographic findings had an increased risk of preterm delivery (relative risk 2.0, 95% confidence interval 1.4 to 2.8), fetal death (relative risk 2.6, 95% confidence interval 1.1 to 6.3), perinatal death (relative risk 2.6, 95% confidence interval 1.3 to 5.3), and neonatal intensive care unit admissions (relative risk 3.2, 95% confidence interval 1.6 to 6.1). The perinatal mortality rate was 258:1000 for patients with abnormal ultrasonographic examinations.
Conclusion: Second-trimester vaginal bleeding is more common in multiparous women and in women with a history of a previous preterm delivery. Perinatal morbidity and mortality is increased in patients with bleeding during the second trimester. The risk is compounded when abnormalities are detected by ultrasonography.</description><subject>Adult</subject><subject>Biological and medical sciences</subject><subject>Case-Control Studies</subject><subject>Diseases of mother, fetus and pregnancy</subject><subject>Female</subject><subject>Fetal Death - epidemiology</subject><subject>Gynecology. Andrology. Obstetrics</subject><subject>high-risk pregnancy</subject><subject>Humans</subject><subject>Intensive Care, Neonatal</subject><subject>Medical sciences</subject><subject>Obstetric Labor, Premature - epidemiology</subject><subject>Parity</subject><subject>Placenta Previa - complications</subject><subject>Pregnancy</subject><subject>Pregnancy Complications, Cardiovascular - diagnostic imaging</subject><subject>Pregnancy Outcome</subject><subject>Pregnancy Trimester, Second</subject><subject>Pregnancy. Fetus. Placenta</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Second-trimester bleeding</subject><subject>Ultrasonography</subject><subject>ultrasonography in pregnancy</subject><subject>Uterine Hemorrhage - diagnostic imaging</subject><issn>0002-9378</issn><issn>1097-6868</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1998</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkU9PGzEQxa2qiKa0HwFpD6gth6W2d-M_XFAVlYKE1APt2fLa42C0sVPbS8W3r5dEOZbTaDS_N2O_h9ApwRcEE_b1HmNMW9lx8UWKc1Eb2vI3aEGw5C0TTLxFiwPyDr3P-XFuqaTH6FguMe4lW6DhHkwMti3JbyAXSM2TXvugx2YYAawP68tmFVOCURcfQxNdM40l6RxDXCe9ffCmcT7MYG7--vLQbCFVfakb4lRM3MAHdOT0mOHjvp6g39fff61u2rufP25X3-5a01NSWkFdJ1g34F4zaYBw0NZqTgwTA8fOCXCWCmIGw7SwohdLZgEw7TQIIcB2J-jTbu82xT9T_Yza-GxgHHWAOGXFJaecSFzBz_8HWY97zPFMLnekSTHnBE5tq086PSuC1ZyCeklBzRYrKdRLCopX3en-wjRswB5Ue9vr_Gw_19no0SUdjM8HjBLe0eWMXe0wqLY9eUgqGw_B1FwSmKJs9K885B-oiKX7</recordid><startdate>19980201</startdate><enddate>19980201</enddate><creator>Signore, Caroline C.</creator><creator>Sood, Anil K.</creator><creator>Richards, Douglas S.</creator><general>Mosby, Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>ASE</scope><scope>FPQ</scope><scope>K6X</scope><scope>7X8</scope></search><sort><creationdate>19980201</creationdate><title>Second-trimester vaginal bleeding: Correlation of ultrasonographic findings with perinatal outcome</title><author>Signore, Caroline C. ; Sood, Anil K. ; Richards, Douglas S.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c421t-82f3863b04a69ce17eadda71c68b70ff8efd281cbc6a8d84856dee023ae888ed3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1998</creationdate><topic>Adult</topic><topic>Biological and medical sciences</topic><topic>Case-Control Studies</topic><topic>Diseases of mother, fetus and pregnancy</topic><topic>Female</topic><topic>Fetal Death - epidemiology</topic><topic>Gynecology. Andrology. Obstetrics</topic><topic>high-risk pregnancy</topic><topic>Humans</topic><topic>Intensive Care, Neonatal</topic><topic>Medical sciences</topic><topic>Obstetric Labor, Premature - epidemiology</topic><topic>Parity</topic><topic>Placenta Previa - complications</topic><topic>Pregnancy</topic><topic>Pregnancy Complications, Cardiovascular - diagnostic imaging</topic><topic>Pregnancy Outcome</topic><topic>Pregnancy Trimester, Second</topic><topic>Pregnancy. Fetus. Placenta</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Second-trimester bleeding</topic><topic>Ultrasonography</topic><topic>ultrasonography in pregnancy</topic><topic>Uterine Hemorrhage - diagnostic imaging</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Signore, Caroline C.</creatorcontrib><creatorcontrib>Sood, Anil K.</creatorcontrib><creatorcontrib>Richards, Douglas S.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>British Nursing Index</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>British Nursing Index</collection><collection>MEDLINE - Academic</collection><jtitle>American journal of obstetrics and gynecology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Signore, Caroline C.</au><au>Sood, Anil K.</au><au>Richards, Douglas S.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Second-trimester vaginal bleeding: Correlation of ultrasonographic findings with perinatal outcome</atitle><jtitle>American journal of obstetrics and gynecology</jtitle><addtitle>Am J Obstet Gynecol</addtitle><date>1998-02-01</date><risdate>1998</risdate><volume>178</volume><issue>2</issue><spage>336</spage><epage>340</epage><pages>336-340</pages><issn>0002-9378</issn><eissn>1097-6868</eissn><coden>AJOGAH</coden><abstract>Objective: Our purpose was to determine the relationship between ultrasonographic findings and perinatal outcome in patients with second-trimester vaginal bleeding.
Study Design: A retrospective case-control study was performed. One hundred sixty-seven patients with ultrasonographic examinations performed for bleeding between 13 and 26 weeks' gestation were identified through a comprehensive ultrasonography database. The main ultrasonographic findings of interest were the presence of an intrauterine clot, membrane separation, and placenta previa. A control group of 167 patients was obtained by selecting the next consecutive patient from the comprehensive perinatal database. Perinatal outcome measures for both groups were recorded.
Results: Multiparity was more common in patients with bleeding than in controls (69% vs 58%,
p=0.036), as was history of two or more previous preterm deliveries (6% vs none,
p=0.005). Second-trimester vaginal bleeding was associated with increased risk of preterm delivery (relative risk 1.9, 95% confidence interval 1.4 to 2.8), fetal death (relative risk 6.3, 95% confidence interval 1.9 to 2.1), and perinatal death (relative risk 5.4, 95% confidence interval 2.1 to 13.7). The perinatal mortality rate was 162:1000 in these patients versus 30:1000 in controls. To assess the impact of ultrasonographic abnormalities, the study group was divided into two groups. Among the patients with second-trimester vaginal bleeding those with abnormal ultrasonographic findings had an increased risk of preterm delivery (relative risk 2.0, 95% confidence interval 1.4 to 2.8), fetal death (relative risk 2.6, 95% confidence interval 1.1 to 6.3), perinatal death (relative risk 2.6, 95% confidence interval 1.3 to 5.3), and neonatal intensive care unit admissions (relative risk 3.2, 95% confidence interval 1.6 to 6.1). The perinatal mortality rate was 258:1000 for patients with abnormal ultrasonographic examinations.
Conclusion: Second-trimester vaginal bleeding is more common in multiparous women and in women with a history of a previous preterm delivery. Perinatal morbidity and mortality is increased in patients with bleeding during the second trimester. The risk is compounded when abnormalities are detected by ultrasonography.</abstract><cop>Philadelphia, PA</cop><pub>Mosby, Inc</pub><pmid>9500496</pmid><doi>10.1016/S0002-9378(98)80022-7</doi><tpages>5</tpages></addata></record> |
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| ispartof | American journal of obstetrics and gynecology, 1998-02, Vol.178 (2), p.336-340 |
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| subjects | Adult Biological and medical sciences Case-Control Studies Diseases of mother, fetus and pregnancy Female Fetal Death - epidemiology Gynecology. Andrology. Obstetrics high-risk pregnancy Humans Intensive Care, Neonatal Medical sciences Obstetric Labor, Premature - epidemiology Parity Placenta Previa - complications Pregnancy Pregnancy Complications, Cardiovascular - diagnostic imaging Pregnancy Outcome Pregnancy Trimester, Second Pregnancy. Fetus. Placenta Retrospective Studies Risk Factors Second-trimester bleeding Ultrasonography ultrasonography in pregnancy Uterine Hemorrhage - diagnostic imaging |
| title | Second-trimester vaginal bleeding: Correlation of ultrasonographic findings with perinatal outcome |
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