Miscarriage among Women in Nablus Governorate

The current study was aimed at evaluating status of miscarriage among women in Nablus governorate. The study investigated the miscarriage categories, causes and possible associated risk factors. The study population included all pregnant women, suffering from vaginal bleeding, admitted to Rafedia Hospital for the years 1999, 2003 (hospital records) and all cases admitted all hospital concerned in obstetrics and gynecology in the city of Nablus during the period January-April 2004. Total number of admitted cases for the year 1999 and 2003 was 412 and 672, respectively. While, total number of women admitted during the first 3 month of the year were 202. The findings of the current study clearly showed a dramatic increase in abortion rate in association with increased maternal age. It was also found that incomplete (43.6%) and missed (23.8%) miscarriage categories were the most prominent categories among current study population (2004). Similar findings in this regard were observed among admitted cases for the years 1999 and 2003. Differences in miscarriage rates according place of residence were statistically significant (P = 0.001). It was also found that 70.3% of the current study population suffered from previous abortions. Although consanguineous marriages were represented by 46%, none seems to suffer from recurrent abortions, thus excluding a significant role of either genetic or immunological factors. History of chronic disease including diabetes, hypertension and endocrine disorders was found among 45% of current study population. Complications from previous abortions included bleeding; infections and surgery were represented by 20%, 16.8% and 5.8%, respectively. Although 91.6% of the study population reported that they have had medical follow up during pregnancy, the findings strongly indicates low level of pregnancy awareness as 49% reported to have unplanned pregnancies, 40% did not take folic acid and 76.2% report the use of medications. With respect to possible risk factors, 28.7%, 91.1%, 66.3%, 83.7% and 74.3% reported active smoking, passive smoking, recurrent genitourinary tract infection, caffeine consumption and exposure to stress, respectively. Such findings again confirm the lack of awareness about possible risk factors for miscarriage. In conclusion our findings on miscarriage causes, awareness and risk factors strongly indicates the urgent need for further investigation as well as the implementation of specially designed health promoting programs targeted towards this group.