Bleeding per vaginum in first trimester of pregnancy: role of Ultrasonography and its clinical correlation

Aims & Objectives of the study: The purpose of this prospective study is to show the importance of ultrasonography in cases of bleeding in first trimester which helps in confirming the pregnancy & precisely identifying the cause of vaginal bleeding occurring in the first trimester and to define correlation of ultrasound findings with clinical diagnosis. Materials and Methods: The present Hospital based prospective cohort study was conducted on 100 patients in our department during the period of eighteen months; from 1stApril 2015 to 31st August 2016. Patients presenting anywhere from the first day of the last menstrual cycle to the first twelve weeks of pregnancy were included. Women of reproductive age with a missed period but a negative urine pregnancy test and patients who refused to admission were excluded Results: Majority of patients in the present study belonged to 26 – 30 years of age. The most common cause of bleeding in first trimester was threatened abortion (32%). The total number of disparities between clinical and ultrasound diagnosis of the causes of bleeding in first trimester was 64%. The accuracy of ultrasound compared to that of clinical diagnosis was 100% in the detection of threatened abortion, blighted ovum, incomplete abortion, complete abortion and vesicular mole. It was found the accuracy was 66.7% in the diagnosis of ectopic pregnancy. Conclusion: Ultrasound is a very valuable tool in the diagnosis of various causes of bleeding per vaginum in first trimester of pregnancy. It is the only imaging modality which is easily accessible and by which an accurate assessment of the first trimester bleeding can be done from diagnostic and prognostic point of view.