First Trimester Bleeding in Pregnancy within the Gynecology and Obstetrics Department of Sourô Sanou Teaching Hospital in BoboDioulasso: 422 Cases Studied and Literature Review

Objectives: Study the epidemiological, clinical, therapeutic and prognostic aspects of the first trimester bleeding of pregnancy. Methodology: This was a descriptive cross-sectional study conducted within the Gynecology and Obstetrics Department of Sourô Sanou Teaching Hospital from January 1st to December 31st, 2019. The study included any patients admitted and treated for endo uterine bleeding in pregnancy with a term inferior or equal to 15 weeks of amenorrhea. The parameters studied were the following: sociodemographic characteristics (age, parity, level of education, occupation, marital status, origin), clinical and paraclinical aspects, diagnosis retained, treatment, and maternal prognosis. Information was collected from a survey form, from clinical records, operating protocols and anatomopathological reports. Data entry and analysis was made through Word and Epi-info 7.2.3 software. Results: During the period of study, 422 cases of first trimester bleeding were reported, corresponding to a frequency of 10.33%. The average age was 29 ± 6.4 years [15-49 years] and the average parity was 1.95 ± 1.7 [0-11]. Married women accounted for 75% of the population. The average gestational age was 9.14 weeks of amenorrhea [5-14 weeks of amenorrhea]. Clinical signs were dominated by vulvar bleeding in 100% of cases and pelvic pains in 86% of cases. All our patients had gone through pelvic ultrasound. As for the diagnoses retained, these included: a threatened abortion in 11.84% of cases, an incomplete abortion (46.77% of cases), an ectopic pregnancy (EP) (26.8% of cases), a terminated pregnancy (17.9% the cases) and a molar pregnancy (8.3% of cases).Abortions were managed through MVA (68.27%) and medical abortion (4.8%). All the cases of EP were treated surgically and no maternal deaths were recorded in our study. Conclusion: First trimester bleeding in pregnancy is common within the department. The main etiologies are threatened abortion, incomplete abortion, molar pregnancy and ectopic pregnancy.