DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20173495

Ultrasonographic evaluation of first trimester bleeding

Awdhut Tiparse, Birwa Gandhi, Arpita Patel

Abstract


Background: Vaginal bleeding in the first trimester is a common obstetric situation ranging from an insignificant episode to life threatening emergency. The major causes are abortion, ectopic, and molar pregnancy. Ultrasonography is playing an increasing role in the diagnostic process. This study was taken up to evaluate its utility vis-à-vis clinical examination findings.

Methods: A Prospective study was carried out on all inpatients admitted to Gopnath Maternity Home, Sir T. Hospital, Bhavnagar with complaints of bleeding per vaginum in the first trimester of pregnancy during the study period from December 2016 to May 2017. A complete general physical and pelvic examination was done to arrive at a clinical diagnosis. Patients were then subjected to ultrasound examination. Clinical diagnosis and ultrasound diagnosis were correlated.

Results: Among these 200 cases, threatened abortion was the commonest cause of bleeding. This was observed in 74 cases (37%). There were 40 (20%) cases of missed abortion in the present study. Incomplete abortion and complete abortion in 14 and 6 cases respectively. There were 26 (13%) cases of ectopic pregnancy.

Conclusions: Ultrasound is a valuable tool in the differentiation of causes of first trimester vaginal bleeding. Ultrasound is helpful in the decision-making algorithm about the safe continuation of the pregnancy, timely intervention for abnormal pregnancy.


Keywords


Abortion, First trimester, Per vaginum bleeding, Ultrasonography

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References


Takeuchi H. Transvaginal ultrasound in the first trimester of pregnancy. Early Human Develop. 1992;29(1-3):381-4.

Paspulati RM, Bhatt S, Nour S. Sonographic evaluation of first trimester bleeding. Radiol Clin North Am. 2004;42:297.

Hurd WW, Whitfield RR, Randolph JF, Kercher ML. Expectant management versus elective curettage for the treatment of spontaneous abortion. Fertil Steril. 1997;68:601-6.

Luise C, Jermy K, May C, Costello G, Collins WP, Bourne TH. Outcome of expectant management of spontaneous first trimester miscarriage: observational study. BMJ. 2002;324:873-5.

Neilsen S, Hahlin M. Expectant management of first-trimester spontaneous abortion. Lancet. 1995;345:84-6.

Chipchase J, James D. Randomised trial of expectant versus surgical management of spontaneous miscarriage. Br J Obstet Gynecol. 1997;104:840-1.

Hemminki E. Treatment of miscarriage: current practice and rationale. Obstet Gynecol. 1998;91:247-53.

Ballagh SA, Harris HA, Demasio K. Is curettage needed for uncomplicated incomplete spontaneous abortion? Am J Obstet Gynecol. 1998;179:1279-82.

Jurkovic D, Ross JA, Nicolaides KH. Expectant management of missed miscarriage. Br J Obstet Gynaecol. 1998;105:670-1.

Duff GB. Prognosis in threatened abortion: a comparison between predictions made by sonar, urinary hormone assays and clinical judgement. Br J Obstet Gynecol. 1975; 82:858-62.

DeCherney AH, Romero R, Polan ML. Ultrasound in reproductive endocrinology. Fertil Steril. 1982;37:323.