Ultrasonographic evaluation of first trimester bleeding

Abstract

INTRODUCTIONUltrasonography is one of the most important and useful diagnostic tool in the field of modern medicine. Being non-invasive, safe and without hazards of radiation, it has gained wide acceptability, as an integral part of basic investigative procedures.The convenience, high portability, rapidity, and accuracy are few of the advantages of ultrasound over the other procedures. In the last two decades, ultrasound has become an essential diagnostic imaging modality in the field of obstetrics and is being extensively used for evaluation of pregnancy. Obstetrical ultrasound enables the clinician to evaluate the development, growth, and wellbeing of the fetus. The ability to study the fetus in the intrauterine environment has been notably enhanced by dramatic improvement in imaging.Transvaginal ultrasound in the first trimester of pregnancy. He commented that recent improvements in transvaginal ultrasound permit the extremely detailed observation of the morphology of the early conceptus in utero. 1Vaginal bleeding is a common presentation in the emergency department during the first trimester. ABSTRACTBackground: 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.

Ultrasound and first-trimester vaginal bleeding: A clinical study.

“…16 According to a study by Tiparse A et al in 2017, 74 (37%) patients were diagnosed as threatened abortions, 14 (7%) cases were diagnosed as incomplete abortions, and 6 (3%) cases were diagnosed as complete abortions. 17 The results of these studies well correlated with the given study, 32 cases (40%) were threatened abortion, 28 cases (35%) be incomplete abortions, and 12 cases (15%) were diagnosed as complete abortions.…”

A molar pregnancy detected by following irregular vaginal bleeding after a first trimester evacuation: rare case report

“…The major causes are abortion, ectopic, and molar pregnancy. 6 The estimated incidence of partial hydatidiform mole (PHM) is 1 in 700 pregnancies whereas the incidence of complete hydatidiform mole (CHM) is around 1 in 1500-2000 pregnancies. 7,8 Approximately 20% of complete moles and 0 to 3.5% of partial moles lead to persistent gestational trophoblastic disease (GTD).…”

Diagnostic evaluation of causes of bleeding per vagina in pregnancy through ultrasonography

“…The invaluable role of these landmarks, the gestational sac and fetal biometry in diagnosing pathological pregnancies and predicting the pregnancy outcome has been clearly documented. 10,11 Maihotra J in his prospective evaluation of 150 patients with first trimester bleeding found that ultrasonography helped in establishing the correct diagnosis in 32% of clinically misdiagnosed cases. 12 He concluded that ultrasonography was the only imaging modality, by which an accurate assessment of first trimester bleeding can be done from the diagnostic and prognostic point of view.…”