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West Afr J Med. 1997 Jan-Mar;16(1):24-6.

Antepartum haemorrhage: the influence of first trimester uterine bleeding.

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  • 1Department of Obstetrics and Gynaecology, University College Hospital, Ibadan, Nigeria.


The influence of first trimester uterine bleeding on the incidence of antepartum haemorrhage was evaluated in 374 patients. The incidence of abruptio placentae and placenta previa were 1.0% and 2.0% respectively in these patients. In the control group of patients who did not experience first trimester uterine bleeding, the incidence was 0.4% for abruptio placentae and 1.0% for placenta previa. The study indicates that first trimester threatened abortion is associated with 2 1/2 fold risk of abruptio placenta and placenta previa than in the general obstetric population. The possible reasons for these incidences are discussed.


A retrospective case-control study suggested that first-trimester threatened abortion is significantly associated with an increased risk of both abruptio placenta and placenta previa. The antenatal and delivery records of 374 women treated at University College Hospital in Ibadan, Nigeria, for period or threatened abortion in the first trimester of pregnancy were compared to those of 500 randomly selected control patients without a history of threatened abortion. Four cases (1.07%) and two controls (0.4%) developed abruptio placenta, while nine cases (2.41%) and five controls (1.0%) had placenta previa. Thus, the risk of both complications was increased 2.5-fold for women with threatened first-trimester abortion. Since bleeding usually indicates some degree of separation of the chorion from decidua, it is speculated that residual tissue defects or weak points remain between the placenta and decidua at the site of bleeding and cause villous, decidua, or chorionic damage. Women with threatened first-trimester abortion should be followed carefully to ensure placental localization.

[PubMed - indexed for MEDLINE]
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