Sundermann Alexandra C, Jasper Elizabeth A, Chumakov Paulina E, Kumar Suchita E, Hartmann Katherine E, Velez Edwards Digna R
Division of Quantitative and Clinical Sciences, Department of Obstetrics and Gynecology, Institute for Medicine and Public Health, and the Department of Biomedical Informatics, Vanderbilt University Medical Center, and the Vanderbilt University School of Medicine, Nashville, Tennessee; and the Department of Obstetrics and Gynecology, University of Kentucky, Lexington, Kentucky.
Obstet Gynecol. 2026 Feb 19. doi: 10.1097/AOG.0000000000006202.
Vaginal bleeding in the first trimester is common, but our understanding of how bleeding relates to the risk of pregnancy loss is limited. In a prospective cohort study, participants provided information on bleeding episodes during early pregnancy and underwent a first-trimester research ultrasonogram. Among 5,425 participants, 25.0% of participants reported first-trimester bleeding, and 12.0% of pregnancies ended in loss. Bleeding was not associated with risk of pregnancy loss (hazard ratio [HR] 0.89, 95% CI, 0.75-1.07). First-trimester bleeding coupled with ultrasound measurements that lagged more than 5 days behind last menstrual period (LMP) dating was associated with increased risk (HR 2.72, 95% CI, 2.10-3.53). These findings indicate that reassurance is appropriate for most patients experiencing first-trimester bleeding when ultrasound measurements align with LMP.
孕早期出现阴道出血很常见，但我们对出血与妊娠丢失风险之间的关系了解有限。在一项前瞻性队列研究中，参与者提供了孕早期出血情况的信息，并接受了孕早期研究超声检查。在5425名参与者中，25.0%的参与者报告有孕早期出血，12.0%的妊娠以流产告终。出血与妊娠丢失风险无关（风险比[HR]为0.89，95%置信区间为0.75-1.07）。孕早期出血且超声测量结果比末次月经日期（LMP）推算日期滞后超过5天与风险增加相关（HR为2.72，95%置信区间为2.10-3.53）。这些发现表明，当超声测量结果与LMP相符时，对于大多数经历孕早期出血的患者来说，给予安心的答复是合适的。
