Introduction: Spontaneous abortion of the second trimester is an interruption of pregnancy with complete expulsion or not of the product of conception between 15 and 28 weeks of pregnancy without any maneuvers. The objective of our study was to determine the factors associated with second trimester spontaneous abortions at Laquintinie Hospital in Douala. Methodology for this purpose: We conducted a case-control study from January to May 2019 on pregnant women who may or may not have had spontaneous second trimester abortions. Results: In total we recorded 1609 pregnancies and recruited 184 patients, including 46 cases and 138 controls; which gave a frequency of spontaneous abortion in the second trimester of pregnancy of 2.85%. A correlative analysis showed that spontaneous abortions in the second trimester were associated with housewife status (OR = 2.89; CI = 1.21 - 6.79; p = 0.010), gestation > 5 (OR = 4.09; CI = 1.02 - 17.66; p = 0.040), multiparity (OR = 3.81; CI = 1.59 - 9.16; p = 0.002), history of endouterine maneuvers (OR = 5.64; CI = 2.43 - 13 .03; p = 0.000), malaria in pregnancy (OR = 3.99; CI = 1.1 - 14.76; p = 0.030), incompleteness on the second trimester ultrasound (OR = 2.37; CI = 1.18 - 4.70; p = 0.010), jolts when traveling (OR = 46.04; CI = 17.29 - 123.66; p = 0.000), long car journeys (OR = 7.05; CI = 1.99 - 27.77; p = 0.000). After logistic regression eliminating the confounding factors, only the following were associated with abortions: Multiparity (OR = 13.90; CI = 2.96 - 65.18; p = 0.000), endo uterine maneuvers (OR = 3.69; CI = 1. 01 - 13.44; p = 0.047), jolts when traveling (OR = 72.63; CI = 19.47 - 270.96; p = 0.000), long car journeys (OR = 15.41; CI = 2.7 - 85, 95; p = 0.000). Conclusion: Our study reveals that a set of factors contribute to the occurrence of spontaneous abortions in the second trimester of pregnancy in our context.
References
[1]
Delabaere, A., Huchon, C., Deffieux, X., Beucher, G., Gallot, V., Nedellec, S., et al. (2014) Epidemiology of Loss Pregnancy. American Journal of Obstetrics & Gynecology, 43, 743-775.
[2]
Leke, R. and Nana, P. (2012) Abortions in Low Resource Countries, Basic Gynecology—Some Related Issues. IntechOpen.
[3]
Cabrol, D., Pons, J. and Goffinet, F. (2003) Traité d’obstétrique. Edition Médecine-Science Flammarion.
[4]
Harold, J. (1982) Congenital Malformations: Etiologic Factors and Their Role in Prevention. The New England Journal of Medicine, 308, 424-429.
[5]
Hawkins, L., Correia, F., Srouji, S., Hornstein, M. and Missmer, S. (2015) Facteurs associés à la perte de grossesse au deuxième trimestre chez les femmes ayant une anatomie utérine normale subissant une fécondation in Vitro. Open Journal of Obstetrics and Gynecology, 125, 621-627.
[6]
Feodor Nilsson, S., Andersen, P., Strandberg-Larsen, K. and Nybo Andersen, A. (2014) Risk Factors for Miscarriage from a Prevention Perspective: A Nationwide Follow-Up Study. BJOG: An International Journal of Obstetrics & Gynaecology, 121, 1375-1385. https://doi.org/10.1111/1471-0528.12694
[7]
McNamee, K.M., Dawood, F. and Farquharson, R.G. (2014) Mid-Trimester Pregnancy Loss. Obstetrics and Gynecology Clinics of North America, 41, 87-102. https://doi.org/10.1016/j.ogc.2013.10.007
[8]
Allanson, B., Jennings, B., Jacques, A., Charles, A.K., Keil, A.D. and Dickinson, J.E. (2010) Infection and Fetal Loss in the Mid-Second Trimester of Pregnancy. Australian and New Zealand Journal of Obstetrics and Gynaecology, 50, 221-225. https://doi.org/10.1111/j.1479-828x.2010.01148.x
[9]
Assebouya, T. (1971) Les avortements à la maternité du centre hospitalier national Yalga-doouedra: Aspects épidémiologiques cliniques et pronostiques. Master’s Thesis, Universite de Ouagadougou.
[10]
Melon, G. (2018) Facteurs associés aux avortements spontanés du deuxième trimestre de grossesse de grossesse à l’Hôpital Gynéco-Obstétrique et Pédiatrique de Yaoundé. Master’s Thesis, Cameroun Université des Montagnes.
[11]
Mc Donald, A., Mc Donald, J. and Armstrong, B. (2007) L’occupation et le résultat de la grossesse. British Journal of Industrial Medicine, 44, 521-526.
[12]
Warburton, D., Stein, Z. and Kline, J. (1980) Les anomalies chromosomiques dans l’avortement spontané: Les données de l’étude de New York City. In: Dans Porter, I.H. and Hook, E.B., Eds., Human Embryogenic et Fetal Death, Academic Press, 261-287.
[13]
Schlesselman, J.J. (1974) Sample Size Requirements in Cohort and Case-Control Studies of Disease. American Journal of Epidemiology, 99, 381-384. https://doi.org/10.1093/oxfordjournals.aje.a121625
[14]
Yamada, T., Morikawa, M., Yamada, T., Kishi, R., Sengoku, K., Endo, T., et al. (2012) First-Trimester Serum Folate Levels and Subsequent Risk of Abortion and Preterm Birth among Japanese Women with Singleton Pregnancies. Archives of Gynecology and Obstetrics, 287, 9-14. https://doi.org/10.1007/s00404-012-2501-5
[15]
Ancel, P.Y. (2000) Risk Factors for 14-21 Week Abortions: A Case-Control Study in Europe. Human Reproduction, 15, 2426-2432. https://doi.org/10.1093/humrep/15.11.2426
[16]
Samaraweera, Y. and Abeysena, C. (2010) Maternal Sleep Deprivation, Sedentary Lifestyle and Cooking Smoke: Risk Factors for Miscarriage: A Case Control Study. Australian and New Zealand Journal of Obstetrics and Gynaecology, 50, 352-357. https://doi.org/10.1111/j.1479-828x.2010.01190.x
[17]
Teguete, I., Maiga, A.W. and Leppert, P.C. (2012) Maternal and Neonatal Outcomes of Grand Multiparas over Two Decades in Mali. Acta Obstetricia et Gynecologica Scandinavica, 91, 580-586. https://doi.org/10.1111/j.1600-0412.2012.01372.x
[18]
Mikulandra, F., Perisa, M., Merlak, I. and Stojnić, E. (1992) The Grand Multipara—An Obstetric Problem? Zentralblatt für Gynäkologie, 114, 491-496.
