First Trimester Bleeding: A Diagnostic Dilemma—Probing It with Ultrasound

Abstract

ABSTRACT Objective The objective of our study was to evaluate the role of ultrasound in the evaluation of patients with first trimester bleeding and to prognosticate and predict the status of abnormal pregnancies. Materials and methods We studied 50 cases of pregnant women who presented with bleeding per vaginum during the first trimester between November 2015 and August 2016. The main sources of data for this study are patients from teaching hospitals attached to Rohilkhand Medical College & Hospital, Bareilly, Uttar Pradesh, India. All patients referred to the Department of Radiodiagnosis with clinically suspected first trimester bleeding were evaluated with clinical history, clinical examination, and ultrasonography (USG). Ultrasonographic examination of patients was done using the following machines: (1) Phillips 350, (2) G.E. logiq V3, and (3) Toshiba 1000. Results Of the 50 cases of first trimester bleeding, 26 cases were diagnosed as threatened abortion clinically, out of which only 12 cases were confirmed. Ultrasound examination confirmed 12 cases of clinically suspected threatened abortions and aids in correctly diagnosing 8 cases that were missed on clinical examination. A total of 12 cases out of 18 threatened abortions continue to term gestation with a successful outcome of 66%. All cases of threatened abortion (n = 18), incomplete abortion (n = 10), missed abortion (n = 4), ectopic pregnancy (n = 4), inevitable abortion (n = 4), blighted ovum (n = 2), and hydatidiform mole (n = 2) were correctly diagnosed on USG. A total of 48 out of 50 cases were correctly diagnosed on ultrasound compared with 18 out of 50 cases on clinical diagnosis, with a disparity of 64%. Four out of five proved ectopic pregnancies were correctly diagnosed both on ultrasound and on clinical examination. Conclusion Ultrasound is noninvasive, nonionizing, without any proved harmful effects on the developing fetus and easily available method of investigation to assess the patients with first trimester bleeding, which is highly accurate in diagnosing the actual causes of bleeding and guides the clinician in choosing the appropriate line of management and prevents mismanagement of the cases. In the present study, 48 out of 50 cases were correctly diagnosed on ultrasound compared with 18 out of 50 cases on clinical diagnosis, with a disparity of 64%. How to cite this article Kumar P, Mehrotra A, Gupta D, Mukharjee S, Saket R, Sinha P. First Trimester Bleeding: A Diagnostic Dilemma—Probing It with Ultrasound. Int J Adv Integ Med Sci 2017;2(3):117-124.