Evaluation of Prothrombin Time, International Normalized Ratio and Platelet Counts among Women Presenting with First-Trimester Vaginal Bleeding: A Prospective Analytical Cross-Sectional Study .
DOI:
https://doi.org/10.51168/7z0tpr73Keywords:
First-trimester vaginal bleeding, Prothrombin time, International normalized ratio, Platelet count, Coagulation profile, Threatened abortion, Pregnancy complicationsAbstract
Background:
First-trimester vaginal bleeding is a common obstetric emergency associated with adverse pregnancy outcomes. Assessment of coagulation parameters may help identify women requiring closer clinical monitoring.
Aim:
To evaluate prothrombin time (PT), international normalized ratio (INR), and platelet count among women presenting with first-trimester vaginal bleeding and determine their association with bleeding severity and clinical diagnosis.
Materials and Methods:
This prospective hospital-based analytical cross-sectional study was conducted at Shri Krishna Medical College and Hospital, Muzaffarpur, Bihar, over 12 months. A total of 180 pregnant women aged 18–40 years with singleton pregnancies, gestational age ≤13 weeks, and first-trimester vaginal bleeding were enrolled. Clinical evaluation, ultrasonography, complete blood count, platelet count, PT, and INR were performed. Data were analysed using SPSS version 26, with appropriate statistical tests; P<0.05 was considered statistically significant.
Results:
The mean age was 26.8 ± 4.5 years, with 41.1% of participants aged 25–30 years. Threatened abortion was the most common diagnosis (54.4%), followed by incomplete abortion (17.8%). Mean PT increased progressively from 12.7 ± 0.8 seconds in threatened abortion to 16.5 ± 1.6 seconds in inevitable abortion (P<0.001). Mean INR increased significantly with bleeding severity, from 1.02 ± 0.09 in mild bleeding to 1.28 ± 0.17 in severe bleeding (P<0.001), while platelet count declined from 2.42 ± 0.47 lakh/mm³ to 1.61 ± 0.36 lakh/mm³ (P<0.001). Abnormal PT, INR, and platelet counts were observed in 19.4%, 16.1%, and 14.4% of participants, respectively. Pregnancy continued in 56.7% of women during follow-up.
Conclusion:
First-trimester vaginal bleeding was associated with significant alterations in PT, INR, and platelet count, particularly with increasing bleeding severity. Coagulation assessment may aid early identification of women requiring closer monitoring.
Recommendation:
PT, INR, and platelet count assessment should be considered alongside clinical evaluation and ultrasonography, particularly in moderate-to-severe bleeding. Further multicentre studies are warranted to validate these findings.
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