Causes of mid trimester pregnancy loss in a tertiary care hospital

Bushra Zardad; Anisa Fawad; Ayesha Ismail; Shazia Mehreen; Sadia Bibi

doi:10.32593/jstmu/Vol3.Iss2.76

Bushra Zardad Registrar, Gynae A Unit, Ayub Teaching Hospital, Abbottabad, Pakistan
Anisa Fawad Professor, Gynae A Unit, Ayub Teaching Hospital, Abbottabad, Pakistan.
Ayesha Ismail Postgraduate trainee, Gynae A Unit, Ayub Teaching Hospital, Abbottabad, Pakistan
Shazia Mehreen Medical Officer, Gynae A Unit, Ayub Teaching Hospital, Abbottabad, Pakistan
Sadia Bibi Registrar, Gynae A Unit, Ayub Teaching Hospital, Abbottabad, Pakistan

DOI: https://doi.org/10.32593/jstmu/Vol3.Iss2.76

Keywords: Mid trimester miscarriages, fibroid uterus, bacterial vaginosis, cervical incompetence, congenital uterine abnormalities

Abstract

Introduction: Mid trimester of pregnancy is relatively a safe time of pregnancy with minimal and no complications. Mid trimester pregnancy loss constitutes 1 to 5 % of total miscarriages. The purpose of this study is to evaluate the causes of second trimester miscarriages so as to improve the outcome in future pregnancies.

Materials & Methods: This was a prospective cross-sectional study. Demographic features, relevant information and risk factors were recorded in a predesigned proforma. Detailed history was followed by thorough clinical examination and appropriate investigations were advised.

Results: Total number of miscarriages admitted in the unit over the period of two years were 336 and among them 30 patients presented with second trimester miscarriages (8.9%). The mean age of the patients was 31.4 years. In 19 patients (63.4%) there were identifiable causes for the miscarriage. 7 patients (23.33%) had fibroids in the uterus, 5 patients (16.67%) had bacterial vaginosis, 4 patients (13.33%) had cervical incompetence and in 3 patients (10%) there were congenital abnormalities in the uterus.

Conclusion: Patients with second trimester pregnancy loss are at significantly increased risk (10 times more likely) for recurrent second trimester loss. In 50 to 70% of patients no cause can be identified. After single loss there is 80% chance of successful pregnancy outcome in future. Even after two and three mid trimester losses still there is 60% chance of alive pregnancy next time, so thorough evaluation and management plan is needed to prevent this mishap in future pregnancies.

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