Correlation between clinical and ultrasonographic diagnosis in patients with first trimester vaginal bleeding

Abstract

Introduction: Amongst the recent advances in obstetrical care, the introduction of ultrasonography has been a major contribution to improvement in prenatal diagnosis. The present study was conducted to correlate the clinical and ultrasonographic diagnosis in cases with bleeding per vaginum during the first 12 weeks of pregnancy.

Material & Methods: A total sample of 150 cases presenting with bleeding per vaginum in first trimester of pregnancy were included in the study. A detailed history and examination was done for all the cases to arrive at a provisional clinical diagnosis. All cases were then subjected to ultrasound examination for confirmation of diagnosis and a definite management was planned.

Results: Maximum number of cases with first trimester bleeding per vaginum belonged to the age group of 18-27 years. Clinically, the most common diagnosis was threatened abortion (86.67%) with remaining cases as missed abortion (5.33%), incomplete abortion (4%), ectopic pregnancy (2%), hydatiform mole (0.67%), threatened abortion with cervical polyp (0.67%) and complete abortion (0.67%). On ultrasonography also, the commonest diagnosis was threatened abortion (44%) showing a discrepancy of 49.23%, thereby, emphasising on a crucial role of ultrasonography in cases with first trimester bleeding per vaginum.

Conclusions: Ultrasound is a very valuable aid in assessment of bleeding per vaginum in first trimester of pregnancy. After ultrasonography, treatment can be more accurately decided thereby saving time and cost of the patients as well as the healthcare system.