Akpan Ubong B, Akpanika Chinyere J, Asibong Udeme, Arogundade Kazeem, Nwagbata Adaolisa E, Etuk Saturday
Department of Obstetrics and Gynaecology, University of Calabar Teaching Hospital, Calabar, NGA.
Department of Family Medicine, University of Calabar Teaching Hospital, Calabar, NGA.
Cureus. 2022 Nov 21;14(11):e31734. doi: 10.7759/cureus.31734. eCollection 2022 Nov.
Pregnancies complicated by threatened miscarriage (TM) may be associated with adverse pregnancy outcomes. The objective of this study was to compare the differences in pregnancy outcomes between the women who experienced TM and asymptomatic controls.
This was a 10-year retrospective review. Case records of 117 women who were managed for TM from January 1, 2010, to December 31, 2019, were retrieved and studied. The control group was developed from an equal number of asymptomatic clients matched for age, parity, and BMI who were receiving antenatal care (ANC) during the same period. Data on demography, clinical and ultrasound findings, treatment, and pregnancy outcomes were retrieved and analyzed.
Spontaneous abortion rate of 13.7% was recorded among the study group compared with 3.4% in the control (P-value [p] = 0.005, odds ratio [OR]: 4.475; 95% confidence interval [CI]: 1.445 - 13.827). Women with TM had higher odds for placenta previa (p = 0.049, OR: 4.77, 95% CI: 2.19 - 23.04), premature rupture of membranes (PROM) (p = 0.028, OR: 1.918, 95% CI: 1.419 - 2.592), postpartum hemorrhage (PPH) (p = 0.001, OR: 2.66, 95% CI: 20.8 - 8.94), and preterm birth (OR: 2.5, 95% CI: 1.75 - 3.65). They were also more likely to undergo cesarean section (p = 0.020, OR: 1.70, 95% CI: 1.053 - 2.964). There was no statistically significant difference in their infants' mean birth weight (3.113 ± 0.585kg for the TM group and 3.285± 0.536kg for the control, P=0.074). Other maternal and perinatal complications were similar. Admission for bed rest significantly improved fetal survival. Women who were not admitted for bed rest had higher odds of pregnancy loss (OR: 3.443, 95% CI: 1.701-7.99). Other treatment plans did not significantly contribute to a positive outcome.
Threatened miscarriage is a significant threat to fetal survival and may increase the risk for operative delivery. Bed rest improves the live birth rate.
妊娠合并先兆流产（TM）可能与不良妊娠结局相关。本研究的目的是比较经历TM的女性与无症状对照组之间妊娠结局的差异。
这是一项为期10年的回顾性研究。检索并研究了2010年1月1日至2019年12月31日期间因TM接受治疗的117名女性的病例记录。对照组由同期接受产前护理（ANC）的年龄、产次和BMI相匹配的同等数量无症状患者组成。检索并分析了人口统计学、临床和超声检查结果、治疗及妊娠结局的数据。
研究组的自然流产率为13.7%，而对照组为3.4%（P值[p]=0.005，优势比[OR]：4.475；95%置信区间[CI]：1.445 - 13.827）。患有TM的女性前置胎盘（p = 0.049，OR：4.77，95%CI：2.19 - 23.04）、胎膜早破（PROM）（p = 0.028，OR：1.918，95%CI：1.419 - 2.592）、产后出血（PPH）（p = 0.001，OR：2.66，95%CI：20.8 - 8.94）和早产（OR：2.5，95%CI：1.75 - 3.65）的几率更高。她们也更有可能接受剖宫产（p = 0.020，OR：1.70，95%CI：1.053 - 2.964）。两组婴儿的平均出生体重无统计学显著差异（TM组为3.113±0.585kg，对照组为3.285±0.536kg，P = 0.074）。其他孕产妇和围产期并发症相似。卧床休息可显著提高胎儿存活率。未卧床休息的女性妊娠丢失几率更高（OR：3.443，95%CI：1.701 - 7.99）。其他治疗方案对良好结局无显著贡献。
先兆流产对胎儿存活构成重大威胁，并可能增加手术分娩的风险。卧床休息可提高活产率。
