Maternal and Fetal Outcomes in Pregnancies Complicated by First-Trimester Vaginal Bleeding – A Cross-Sectional Study

Open Access

Abstract

Background: First-trimester vaginal bleeding is a frequent obstetric presentation often associated with anxiety regarding pregnancy viability. Emerging evidence suggests that early pregnancy bleeding may have lasting implications for both maternal and fetal health beyond the first trimester. This study aimed to evaluate maternal and fetal outcomes in pregnancies complicated by first-trimester vaginal bleeding. Methods: This cross-sectional observational study was conducted at the Department of Obstetrics and Gynecology, Bangladesh Medical University, Dhaka, from July 2024 to June 2025. A total of 120 pregnant women with vaginal bleeding at ≤12 weeks of gestation were enrolled. Participants were followed up until pregnancy outcomes were determined. Maternal complications and fetal–neonatal outcomes were documented. Data were analyzed using SPSS version 25.0. Results: Miscarriage before 20 weeks occurred in 23.3% of cases. Among the ongoing pregnancies, 52.5% resulted in term deliveries and 24.2% were preterm. Pregnancy-induced hypertension (11.7%) and gestational diabetes mellitus (9.2%) were the most common complications. Low birth weight was observed in 29.3% of neonates, NICU admission in 22.8%, low Apgar score in 14.1% and stillbirth in 5.4% of the cases. Conclusion: First-trimester vaginal bleeding is associated with an increased risk of adverse maternal and fetal outcomes. Pregnancy complicated by early bleeding requires close antenatal monitoring to improve the perinatal outcomes.