title: Incidence and outcome of bleeding before the 20th week of pregnancy: prospective study from general practice.
abstract: OBJECTIVE
  To estimate the miscarriage rate in a cohort of pregnant women and the final outcome of pregnancy.
  
  
  METHODS
  Two year prospective community study.
  
  
  METHODS
  Women registered with four semirural practices at one health centre.
  
  
  METHODS
  626 pregnant women from a population 21448, 5140 of whom were women aged 15-44 years.
  
  
  METHODS
  Vaginal bleeding and outcome of pregnancy.
  
  
  RESULTS
  76 of the 89 women with an unwanted pregnancy requested a termination. In the 550 ongoing pregnancies bleeding occurred before the 20th week in 117 (21%), and 67 (12%) ended in miscarriage. The risk of miscarriage was not significantly increased after a miscarriage in the previous pregnancy (11 (15%) women had miscarriage v 55 (12%) women who had not had miscarriage) who had previously had a live birth). Of the 117 women with bleeding, 64 were not admitted to hospital by the general practitioner; 42 of these women had an ultrasound examination at the health centre and 19 subsequently miscarried at home. In hospital 41 of 46 women who miscarried had evacuation of the uterus.
  
  
  CONCLUSIONS
  Bleeding occurred in one fifth of recognised pregnancies before the 20th week and over half of these miscarried. Treatment of women with miscarriage at home means current statistics on miscarriage in Britain are missing many cases.
authors.affiliation: Alton Health Centre, Hampshire.
authors.forename: C
authors.initials: C
authors.lastname: Everett
mesh_terms: D000029:Abortion, Legal; D000022:Abortion, Spontaneous / Q000453:epidemiology*; D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D005194:Family Practice / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D015994:Incidence; D011247:Pregnancy; D011256:Pregnancy Outcome; D011261:Pregnancy Trimester, First; D011262:Pregnancy Trimester, Second; D011446:Prospective Studies