Ultrasonographic evaluation of first trimester bleeding per vaginum

Neelam Gupta, Meenakshi Samariya, Devika Choudhary, Kanti Yadav, Pushpa Kannoujiya


Background: First trimester is a very crucial period of pregnancy having high risks of pregnancy losses. The objective of this study was to assess the accuracy of ultrasound in diagnosis of cause of first trimester bleeding per vaginum.

Methods: 200 women who attended the out-patient department with the complaint of bleeding per vagina in the first trimester pregnancy were taken for the study. Clinical assessment by pelvic examination was done and a provisional diagnosis was made. All necessary routine investigations were done followed by ultrasonographic scan of each patient. All the data was recorded in a proforma.

Results: Among these 200 cases, threatened abortion in 72 cases. It was the commonest cause for bleeding. There were 20 cases of ectopic pregnancy out of which 16 were correctly diagnosed. There were 16 cases of missed abortion. There were 8 cases of hydatidi form mole. There were 40 cases of incomplete abortion, 16 cases of inevitable abortion, 8 cases of an embryonic gestation and 20 cases of complete abortion. By this study it is concluded that the accuracy of USG in diagnosing the cause of first trimester bleeding per vaginum is 96%.

Conclusions: Use of USG in diagnosis of cause of bleeding in first trimester can lead to accurate and early diagnosis and save the patients from unneeded interventions based on history and clinical examination.


USG, Abortion, Ectopic pregnancy, Hydatidiform mole, Bleeding per vaginum

Full Text:



Yadav V, Santosh, Bharathi. Ultra sonographic evaluation and management of the first trimester bleeding. IOSR Journal of Dental and Medical Sciences. 2015;14(12):43-6.

Abdallah Y, Daemen A, Kirk E, Pexsters A, Naji O, Stalder C, et al. Limitations of current definitions of miscarriage using mean gestational sac diameter and crown-rump length measurements: a multicenter observational study. Ultrasound Obstet Gynecol. 2011;38(5):497-502.

Hanamshetty A, Hattarki SM. Ultra sound evaluation of first trimester bleeding. Journal of Evidence based Medicine and Healthcare. 2014;1(10):1356-61.

Kurmi D, Jadhav VR, Misri A, Mishra N, Prabhu S, Savani G. Role of pelvic sonography in first trimester bleeding. Journal of Evolution of Medical and Dental Sciences. 2015;4(49)8516-25.

Mamatha S, Sagar SG, Manoli N. Ultrasound evaluation of vaginal bleeding in first trimester of pregnancy: a comparative study with clinical examination. Int J Sci Stud. 2015;3(7):202-6.

Manoli N, Ramamurthy H. Role of ultrasound in first trimester bleeding - a study. Scholar's Press. 2013;2012.

Vidya C, Sanjaya S. Ultra sonographic evaluation of first trimestervaginal bleeding. Jarbs. 2011;3(2):60-2.

Padmaja P, Somashekar S. First trimester vaginal bleeding - evaluation by ultrasound. Indian journal of applied research. 2015;5:6.