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Relationship between first trimester vaginal bleeding and the risk of placental abruption

Hatice Akkaya, Gulsum Uysal.


The aim of this study was to analyze influence of first trimester vaginal bleeding on the risk of placental abruption, as well as to assess the relation of first trimester bleeding and perinatal outcome in this patients with placental abruption. The second objective was to assess the connection of first trimester bleeding with low pregnancy-associated plasma protein-A and maternal serum alpha-fetoprotein with placental abruption. This is the first study that evaluated all relations these analytes in placental abruption with first trimester bleeding. Spontaneous, singleton pregnancies with live fetus ≥26 weeks of gestation with placental abruption were divided into two groups based on their prensence of first-trimester bleeding (Group 1) or without (Group 2). Maternal age, parity, smoking habits, body mass index, history of abortion and abruption, levels of pregnancy-associated plasma protein-A and Alpha-fetoprotein were also analyzed and compared. Main outcome measures were, mean gestational age, gender of baby, APGAR scores, birth length and weight and cesarean section rates. A total of 122 patients were included in the study.There were 44 patients accompanied with first trimester bleeding (group 1) and 78 patients without first trimester bleeding (group 2). The neonatal birthweight was significantly lower in first trimester bleeding group. The rate of smoking mother was significantly higher in first trimester bleeding group. Regarding serum maternal biomarkers, pregnancy-associated plasma protein-A≤0.5 and Alpha-fetoprotein ≥2 MOM was significantly higher in first trimester bleeding group.First trimester bleeding should alert clinicians for the signs of later possible complications in addition to low regnancy-associated plasma protein-A(≤0.5 MOM) and higher Alpha-fetoprotein (≥2 MOM) levels. Presence of vaginal bleeding in first trimester are related with poor maternal and fetal outcome at birth in patient with placental abruption.

Key words: First trimester vaginal bleeding, Placental abruption, Pregnancy-associated plasma protein-A, serum alpha-feto protein

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