Sonographic Evaluation Of First Trimester Bleeding And It’s Outcome

Abstract

Background : First trimester vaginal bleeding is a common condition, occurring in approximately 16 – 20 % of pregnant women. The important causes of first trimester bleeding include inevitable abortion, missed abortion, incomplete abortion, complete abortion, molar pregnancy, ectopic pregnancy, implantation bleeding, subchorionic bleeding and threatened abortion. Some of the above mentioned conditions are absolute indications for termination of pregnancy which can be missed by clinical diagnosis alone. Ultrasonography aids in diagnosing these conditions accurately. Objective: To evaluate the causes and complications of first trimester bleeding and to identify high risk pregnancy which warrants termination of pregnancy . Method: It is a randomized prospective study conducted in 128 pregnant women < 12 weeks of Gestation with bleeding PV attending DEPT. of OBG of Shri. B.M.Patil medical college BLDE university, Bijapur. After taking in to consideration the inclusion and exclusion criteria, all 128 patients were included into the study and subjected to ultrasound examination.

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Results: In our study of 128 cases, 40 cases were threatened abortion, 20 cases were complete abortion, 15 cases were missed abortion, 15 cases were inomplete abortion, 14 cases were inevitable abortion, 3 cases were blighted ovun, 8 cases were ectopic pregnancy and 6 cases were molar pregnancy. In these 128 cases, 93 ended in pregnancy failure. In 40 cases of threatened abortion, 21 cases had full term normal delivery, 7 cases had pre term delivery, 2 cases had spontanious abortion, 3 cases underwent mtp with tubectomy and 7 cases lost follow up . The diagnosis by ultrasound wad done in all cases except in 2 cases, one is molar pregnancy which was diagnosed by HPR. Other one was ectopic pregnancy, diagnosed during laparotomy. The diagnostic accuracy of ultrasound in this study is 98.5%. Conclusion: Ultrasound is safe, non invasive and accurate method of diagnosis in first trimester bleeding and its outcome.