A Study on Obstetric Outcome after Previous Spontaneous Abortions.

Background: In this study, we wanted to evaluate the incidence of adverse outcomes in pregnancy preceded by spontaneous abortion compared to those preceded by full term live births. Materials and methods: This was a hospital based prospective observational study conducted among 200 pregnant women with history of previous spontaneous abortions attending the antenatal OPD and labour room in the Department of Obstetrics and Gynaecology, J.L.N Hospital and Research Centre, Bhilai, Chhattisgarh, over a period of 11 months from 1^st December 2019 to 30^th October 2020 after obtaining clearance from Institutional Ethics Committee and written informed consent from the study participants. Results: The incidence of oligohydramnios in case and control groups was 13 and 4% respectively. This has a p value of 0.022 which was statistically significant. The incidence of premature rupture of membrane (PROM) in case and control groups was 22 and 11 % respectively. This has a p value of 0.03 which was statistically significant. The incidence of PPROM in case and control groups was 7 and 1 % respectively. This has a p value of 0.03 which was statistically significant. 65.59 % patients underwent lower segment caesarean section (LSCS) among cases and 50 % patients underwent LSCS among controls. This has a p value of 0.037 which was statistically significant. 5.41 % of cases had emergency caesarean section while 57.14 % of controls had emergency caesarean section which was statistically significant (p value 0.042). 42.86 % of controls had elective caesarean section owing to large number of patients in control group with history of previous caesarean scar. Conclusion: Previous unfavourable pregnancy outcome increases the risk of adverse outcome in the future pregnancies. Majority of abortions in present pregnancy among both cases and controls are of first trimester abortions. There was significant association found between previous spontaneous abortion and oligohydramnios (13%), preterm delivery (16%), PROM (22%), PPROM (7 %), low birth weight (18.28 %), in the subsequent pregnancies. As the number of abortions increases, the incidence of term pregnancies decreases (A1-80.72%, A2-63.64 %, A3 - 60%, A4 - 0%). As the number of abortion increases, the incidence of oligohydramnios increases. The percentage of operative deliveries increases in the cases who had previous abortions. There was significant number of neonatal intensive care unit (NICU) admissions among cases. Previous abortions have a definite impact on the successful outcome of future pregnancies hence history of abortions in previous pregnancy should be investigated and treated. [ABSTRACT FROM AUTHOR]