Antepartum haemorrhage (APH) is defined as bleeding from the genital tract in pregnancy which occurs after 20 completed weeks of gestation. Research surrounding APH and pregnancy outcomes has been mainly retrospective work. It suggests that APH is associated with higher rates of adverse pregnancy outcomes. The objectives of this study were to prospectively study women experiencing APH to ascertain if such pregnancies are truly high risk.
This is a prospective study conducted at Cork University Maternity Hospital, Ireland, from June 2009 to 2010. Cases were identified in the Emergency Room and controls were selected from the National Perinatal Epidemiology Centre (NPEC) database. Visual blood loss charts were used to aid in assessing volume of blood lost and a datasheet was completed on each patient, together with ongoing monitoring of blood loss during inpatient stays.
84 patients were recruited to the original group. 797 patients made up the NPEC exposed group. Data from these groups was compared against 7715 controls identified in the NPEC database. No significant difference in birthweight, mode of delivery, term induction rate or NICU admission rate was found between the groups. Statistically significant differences in rates of preterm delivery were found with a 4-fold increase in preterm birth in the original exposed group when compared with controls.
This study has identified that women experiencing APH are four times more likely to experience preterm birth in that pregnancy. This information is important for both patients experiencing this pregnancy complication and clinicians involved in their care.
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