Vaginal bleeding and nausea in early pregnancy as predictors
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While nausea and vaginal bleeding are commonly experienced in early pregnancy, their prognostic value in predicting clinical pregnancy loss is not well understood. A study was done to understand whether the timing of bleeding and nausea symptoms can be used to predict the risk of pregnancy loss among women with ultrasound confirmed pregnancies.

Among 701 women, 38% reported any vaginal bleeding and 92% reported any nausea. Most bleeding was spotting and contained within a single episode. Vaginal bleeding occurred in 16%, 15%, and 21% of women within weeks 2-4, 4-6, and 6-8, respectively. Nausea was reported in 33%, 66% (68% live birth, 60% clinical loss), and 87% of women within these respective epochs. Bleeding in the absence of nausea at 6-8 weeks’ gestation (3.6% prevalence) had the greatest risk of clinical loss, a positive predictive value of 68%, the negative predictive value of 86%, the positive likelihood ratio of 11, and negative likelihood ratio of 0.86. This symptom pattern predicted clinical pregnancy loss similar to age, BMI, blood pressure, and waist to hip ratio measured preconceptionally.

In conclusion women experiencing bleeding 6-8 weeks’ gestation without accompanying nausea had an elevated risk of clinical pregnancy loss. Bleeding or nausea prior to 6 weeks’ gestation were not predictive of the risk of clinical loss.

Source:https://www.ajog.org/article/S0002-9378(20)30426-9/fulltext?rss=yes
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