First-trimester vaginal bleeding and its impact on pregnancy outcomes: A prospective observational study

Abstract

Background: First-trimester vaginal bleeding (FTVB) is a common early pregnancy presentation and has been associated with increased risk of adverse pregnancy outcomes. This prospective observational study aimed to determine pregnancy outcomes in women presenting with FTVB at a tertiary care centre in northern India. Methods: From May 2024 to May 2025, antenatal women with singleton pregnancy and any vaginal bleeding within the first 14 weeks gestation who presented to the Department of Obstetrics and Gynaecology, Rohilkhand Medical College And Hospital, were screened and consecutively recruited. Demographic, clinical, sonographic, and follow-up outcome data were collected Results: Mean age was 27.9 ± 4.8 years, and 60.9% were primigravida. Abortion occurred in 11 (11.9%) cases, preterm labour in 18 (19.6%), and full-term delivery in 63 (68.5%). Preterm labour was significantly higher among women who bled before 8 weeks compared with those after 8 weeks (p=0.037). Placental abruption occurred in 8.7%, PROM in 6.5%, and anemia in 4.3%. Cesarean section was performed in 47.8% of cases. Neonatal mean birthweight was 2.78 ± 0.41 kg, and 83.7% had APGAR ?7 at 5 minutes. Conclusion: Although most pregnancies with FTVB progress to term, early bleeding (<8 weeks) significantly increases the risk of preterm labour and placental complications. Early diagnosis, progesterone support, and vigilant antenatal follow-up improve maternal and fetal outcomes.