Outcome of Pregnancies Complicated by Early Vaginal Bleeding

Obstetrical and neonatal data were analysed for pregnancy outcome in 259 deliveries complicated by first or second trimester vaginal bleeding. There was a high incidence of low birth weight, low gestational age, perinatal death, asphyxia, breech delivery, placental infarcts and small-for-dates term infants. Fetal anomalies were slightly though not significantly increased. Combined suboptimal pregnancy outcome occurred in 29.7 per cent of these deliveries compared to 15.2 per cent of 25 118 concurrent deliveries without reported early pregnancy bleeding (p less than 0.0001). The combined risk remained approximately doubled even for primigravidae and for women without prior illness or pregnancy complications. The highest combined risk, 61.5 per cent, was for women with at least two prior abortions, premature births or perinatal deaths and no prior term births. These findings suggest that early gestational vaginal bleeding is one predictor of suboptimal pregnancy outcome.