Vaginal Bleeding in the Last Two Trimesters of Pregnancy a Clinical and Ultrasonic Study

Ninety-seven cases of vaginal bleeding during the second and third trimesters of pregnancy are presented with special reference to the follow-up observations and perinatal parameters after the first bleeding and ultrasonic determination of placental site. The perinatal mortality rate was 11 per cent and the rate of premature deliveries 23 per cent. In the cases of recurrent bleeding episodes (N = 33), the corresponding frequencies were 22 and 35 per cent. Placenta previa of some degree was diagnosed by ultrasound during the first episode of bleeding in 36 cases. Although the placenta was observed to "move" upwards from the internal os of cervix in 20 of these patients during the last few weeks of pregnancy, final placenta previa (N = 16) was the most common definite etiological factor behind the bleeding. The high frequency of perinatal complications associated with these pregnancies emphasizes, despite reliable localization of the placenta, the importance of a careful follow-up until delivery.