Outcome of Threatened Miscarriage at the University College Hospital, Ibadan, Nigeria Between 2016 And 2020

Abstract

Background

Threatened miscarriage is one of the most common complications of pregnancy and it is a pregnancy-related bloody vaginal discharge or frank bleeding during the first half of pregnancy without cervical dilatation. Threatened miscarriage occurs in 20-25% of ongoing pregnancy with variations based on location, age, number of pregnancies etc.

Objectives

This study therefore seeks to know the incidence of threatened miscarriage, the eventual outcome of cases of threatened miscarriage and the factors associated with the continuation of pregnancy after threatened miscarriage occurred between 1st January, 2016 and 31st December, 2020 in the University College Hospital, Ibadan.

Methods

This was a 5-year retrospective descriptive study analysing the case records of all pregnant women in the gynaecology wards who were admitted for threatened miscarriage between 1st January, 2016 and 31st December, 2020 at the University College Hospital (UCH), Ibadan, Nigeria. The names and hospital numbers of all cases of threatened miscarriage were obtained from the admission registers and the casefiles were retrieved from the Records Department of UCH from which all needed data for the study were collated. The dependent variable was the outcome of the threatened miscarriage. Descriptive statistics were used for variable, Pearson’s Chi square or the Fisher’s exact test and Independent Students’ t-test compared, as applicable, across groups for categorical and continuous data and a p-value of < 0.05 interpreted as a statistically significant correlation. Binary logistic regression analyses examined for associations between outcome of the threatened miscarriage and the significant independent variables.

Results

There were 4,014 gynecology wards admissions of which 320 were cases of threatened miscarriage. This gave an incidence rate of 7.97% (approximately 80 cases of threatened miscarriage per 1000 gynaecology admissions) for threatened miscarriage in UCH for the period studied. Out of the 320cases of threatened miscarriages, 287 (89.69%) casefiles were retrieved, captured and analysed. From these 287cases, 159 (55.4%) had subsequent complete miscarriage (outcome losses), while 107 (37.3%) carried the pregnancy beyond age of viability. There were 21 (7.3%) cases whose outcome could not be traced. 94.6% of those without outcome losses were booked patients (p-value <0.001). Binary logistic regression revealed that light bleeding volume (OR=5.140, p-value<0.001) and antenatal booking (OR=7.902, p-value<0.001) are factors that increased the chances of continuation of pregnancy after threatened miscarriage occurred in the participants.

Conclusion

This study shows that the incidence of threatened miscarriage is 7.97% with about 55.4% resulting in pregnancy loss while 37.3% proceeded beyond the age of viability. Women with history of scanty bleeding at presentation and those who had early antenatal booking had increased chances of continuation of pregnancy after occurrence of threatened miscarriage.