Pregnancy is a period of wonderful time of anticipation but when it ends in spontaneous second trimester abortion, it can be an intensely sad and frightening experience to the expectant parents.

Objective[s]:1.Early identification of high risk pregnancy patients.

2. To determine the risk factors associated with spontaneous second trimester abortion.

Materials and Methods: This is a case control study conducted in Sree Avittom Thirunal Hospital Trivandrum over a period of 1year. study group with all cases of spontaneous second trimester abortion admitted in hospital and control with registered antenatal patients who have completed 24 weeks of pregnancy..During the study period 156 cases in study group compared with 156 control group.

Results: In the present study women with positive past medical history had 2.5 times increased risk of second trimester abortion. Women with previous pregnancy loss had 3 times increased risk and history of cervical incompetence had 7 times increased risk when compared to control group.

Conclusion: This study suggest that women with spontaneous second trimester abortion should be informed of their pregnancy expectations and outcome. Improved Obstetrics care can provide successful pregnancy for the great majority of these high risk women. Appropriate interventions can prevent some of antepartum complications.

Keywords: Risk Factor, Second Trimester Abortion.

1. Lesly Regan, Katy Clifford – Sporadic and recurrent miscarriage- TurBull’s obstetrics 3^rd edition page 117.
2. Text book of obstetrics including perinatology and contraception - D C Dutta sixth edition 2004
3. Garay Cunningham William obstetrics 22^ndedition page 231-235
4. Rasmussen S, Albrechtsen, Igrens LM et al: unexplained fetal death with maternal and fetal characteristics. Early Hum Dev 2003 71(1) 39-52 (ISSN 0378-03782)
5. Frias A E,Luikenaar RA, Sullivan A E, Lee R M, Porter T F, Branch D W, Sculer R M.  Poor obstetric outcome in subsequent pregnancies in women with prior fetal death.Obstet  Gynecol 204;104 (3);521-6 ISSN  0029-7844
6. SZ Omar, V Sivanesaratnam, P Damo-daran. Lower segment myoma – Report of 2 cases SMJ Med J 1999 Vol. 40 (02).
7. Michael Prysak, Robert P Lorenz and Anne Kisly. Pregnancy outcome in nulliparous women 35 year and older Am. J Obstet Gynecol 85:65, 1994
8. Tremewan RN, Chandra M, Duff GB. The mid trimester low lying placenta : a prospective study NZ Med J – 1980 Aug 27;92(666): 151-3 (Pub Med)
9. Alonso A, Ogunyemi D, Ku W, Arkely. The association between inherited thrombophilia, antiphospholipid antibodies and lipo protein A level with obstetrical complications in pregnancy. J Thromb Thrombolysis 2002 Oct; 14 (2): 157-62
10. Newman RB Multiple gestation Clinical Obstetrics and Gynaecology Eippin Cot 2004; 47(1): 116-117
11. Weiss JC, Malore FD, Vidaver J, Ball RH, Nyberg DA, Comstick CH, Hankins GD, Berkowitz RL, Gross SL, Dugoffl, Timor Tritsch IE, D’Alton ME, - Threatened abortion, A risk factor of poor pregnancy outcome, a population bases screening study. Am J Obstet Gynecol 2004; 190:745-750.

Dr Simi Jameela

Assistant Professor, Department of Obstetrics and Gynaecology,

Sree Avittom Thirunal, Trivandrum, India