Incidence and outcome of bleeding before the 20th week of pregnancy: prospective study from general practice.
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.
Everett
C
C
Alton Health Centre, Hampshire.
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