BLEEDING IN EARLY PREGNANCY;

Abstract

Objectives: (1) To determine various ways of presentation of bleeding in earlypregnancy. (2) To classify the different causes of bleeding in early pregnancy. Study Design:A descriptive observational study. Place and Duration of Study: This study was done in AzizBhatti Hospital Gujarat attached with Nawaz Sharif Medical College (U.O.G) for a period ofone year during 2014-15. Methodology: The patients who presented with the complaint ofbleeding in early pregnancy before twentieth weeks of gestation were included in the study.The patients who presented after this gestational age and the patients with DUB or any otherincidental cause were excluded. Results: Majority of the patients presented between the agesof 21 to 30 years, and the miscarriage was in the embryonic period. The other ways were painand passage of vesicles (4%). Shoulder tip pain and fainting attacks were the other associatedsymptoms, twenty two percent presented with disappearance of pregnancy symptoms, only4% patients presented with loss of fetal movements. The important predisposing factors werehistory of I.U.C.D, spontaneous miscarriage; E&C and 6% with history of recurrent miscarriages,diabetes, UTI. The most common were incomplete miscarriages. Second commonest werethreatened. Two important diagnostic aids were U.S.G. (TVS) and vaginal examination to classifythe causes of bleeding. Conclusion: Bleeding is the commonest complaint with which thepregnant population presents. The commonest cause is incomplete miscarriage followed bythreatened miscarriage; ultrasonography is of utmost importance for diagnosis. The expectantmanagement of complete miscarriage in selected cases when not bleeding heavily should beconsidered. The patients with inevitable abortion should be evacuated under aseptic conditions.The most serious causes e.g. ectopic pregnancy, molar pregnancy, missed miscarriage andincidental local causes should always be kept in mind.