scholarly journals Ultrasonographic evaluation of first trimester bleeding

2017 ◽  
Vol 6 (8) ◽  
pp. 3614
Author(s):  
Awdhut Tiparse ◽  
Birwa Gandhi ◽  
Arpita Patel
Keyword(s):  
Clinical Diagnosis ◽  
Vaginal Bleeding ◽  
First Trimester ◽  
Diagnostic Process ◽  
Life Threatening ◽  
Threatened Abortion ◽  
First Trimester Of Pregnancy ◽  
General Physical ◽  
A Prospective Study ◽  
Maternity Home

Background: Vaginal bleeding in the first trimester is a common obstetric situation ranging from an insignificant episode to life threatening emergency. The major causes are abortion, ectopic, and molar pregnancy. Ultrasonography is playing an increasing role in the diagnostic process. This study was taken up to evaluate its utility vis-à-vis clinical examination findings.Methods: A Prospective study was carried out on all inpatients admitted to Gopnath Maternity Home, Sir T. Hospital, Bhavnagar with complaints of bleeding per vaginum in the first trimester of pregnancy during the study period from December 2016 to May 2017. A complete general physical and pelvic examination was done to arrive at a clinical diagnosis. Patients were then subjected to ultrasound examination. Clinical diagnosis and ultrasound diagnosis were correlated.Results: Among these 200 cases, threatened abortion was the commonest cause of bleeding. This was observed in 74 cases (37%). There were 40 (20%) cases of missed abortion in the present study. Incomplete abortion and complete abortion in 14 and 6 cases respectively. There were 26 (13%) cases of ectopic pregnancy.Conclusions: Ultrasound is a valuable tool in the differentiation of causes of first trimester vaginal bleeding. Ultrasound is helpful in the decision-making algorithm about the safe continuation of the pregnancy, timely intervention for abnormal pregnancy.

scholarly journals Diagnostic evaluation of causes of bleeding per vagina in pregnancy through ultrasonography

2019 ◽  
Vol 8 (4) ◽  
pp. 1369
Author(s):  
Sumathy K. K.
Keyword(s):  
Vaginal Bleeding ◽  
First Trimester ◽  
Diagnostic Process ◽  
Chi Square ◽  
Emergency Ultrasonography ◽  
Chi Square Test ◽  
Life Threatening ◽  
Abruptio Placenta ◽  
Test Of Significance ◽  
General Physical

Background: Vaginal bleeding is a common obstetric situation ranging from an insignificant episode to life threatening emergency. Ultrasonography is playing an increasing role in the diagnostic process. The objective of present study was to evaluate the uses of ultrasound as new diagnostic aid for patients of bleeding PV in pregnancy.Methods: A hospital-based prospective study was conducted among 100 pregnant patients who have the problem of bleeding. A complete general physical and pelvic examination was done, and patients were then subjected to ultrasound examination. Epi info 7 software was used for statistical analysis. Chi- square test was used as the test of significance. P<0.05 is considered statistically significant.Results: Among these 100 cases, Incomplete abortion was the commonest cause of bleeding. This was observed in 15 cases (27%). There were 8 (20%) cases of complete abortion in the present study in the scan done on <20 weeks. Abruptio placenta was seen in 10 (25%) cases as the most common cause in the scan after 20 weeks.Conclusions: Ultrasound is a valuable tool in the differentiation of causes of first trimester vaginal bleeding. Ultrasound is helpful in the decision-making algorithm about the safe continuation of the pregnancy, timely intervention for abnormal pregnancy.

scholarly journals Sonological Evaluation of Causes of First Trimester Bleeding

KYAMC Journal ◽  
2019 ◽  
Vol 10 (1) ◽  
pp. 25-30
Author(s):  
Salma Chowdhury ◽  
Tanvirul Hasan ◽  
Mir Moyeedul Islam ◽  
Susmita Nargis ◽  
ABM Moniruddin
Keyword(s):  
Vaginal Bleeding ◽  
First Trimester ◽  
Clinical Findings ◽  
Diagnostic Modality ◽  
Abdominal Sonography ◽  
General Physical Examination ◽  
Obstetric Management ◽  
Life Threatening ◽  
Threatened Abortion ◽  
General Physical

Background: Per vaginal bleeding in the first trimester is a common obstetrical situation ranging from an insignificant episode to life threatening emergency. The major causes are abortion, ectopic and molar pregnancies. Objectives of study: Ultrasonography is playing an increasing role in diagnosis of causes of Per vaginal bleeding in the first. This study was taken up to evaluate the value and utility of ultrasonography in correlation to the clinical findings of Per vaginal bleeding in the first trimester (sonographic evaluation). Materials and Methods: In this prospective study all obstetric cases (with a history of per vaginal bleeding in the first trimester of pregnancy between April, 2015 to November, 2015 (of 8 months) were included. A complete general physical examination including pelvic examination was done to arrive at a clinical diagnosis. Patients were then subjected to ultrasound examination. Clinical and ultrasound findings were correlated. We attempted to indentify the causes of vaginal bleeding occurring in the first trimester by clinical and trans-abdominal sonography and to evaluate the outcomes after instituting appropriate obstetric management. Results: Fatytun of all obstetric cases (200) had the First trimester bleeding (incidence being 21%). The common causes were abortion (85.68%), molar (9.52%) and ectopic (4.80%) pregnancies. The bleeding cases were common in the younger age group 21 to 25years, more in the multigravida within 5 to 8(47%) weeks of gestational age. The commonest cause of bleeding was threatened abortion (28.57%). Early institution of treatment after proper diagnosis has decreased morbidity, at times mortality of women. Ultrasound had not only clinched the diagnosis but also helped in timely management of first trimester vaginal bleeding. Conclusion: Ultrasound is a simple, non-invasive diagnostic modality available in the current day practice to diagnose and to manage first trimester vaginal bleeding. KYAMC Journal Vol. 10, No.-1, April 2019, Page 25-30

scholarly journals Clinical study of role of ultrasound in first trimester vaginal bleeding

2020 ◽  
Vol 9 (10) ◽  
pp. 4010
Author(s):  
Sandyashree P. K. ◽  
Swathi Nayak C. V.
Keyword(s):  
Ectopic Pregnancy ◽  
Clinical Diagnosis ◽  
Vaginal Bleeding ◽  
Correct Diagnosis ◽  
Cost Effective ◽  
First Trimester ◽  
Statistical Correlation ◽  
Ultrasound Diagnosis ◽  
General Physical ◽  
Sensitivity Specificity

Background: Vaginal bleeding is a serious cause which needs an emergency consultation. Major causes are abortion, ectopic pregnancy and molar pregnancy others like cervical erosion, polyp and carcinoma. The objective is to identify cause, assess the prognosis and institute appropriate management.Methods: Prospective study in MMC and RI, OBG, Mysore from November 2015 to September 2017. General physical and pelvic examination done for provisional clinical diagnosis and subjected to Ultrasound. Clinical diagnosis and ultrasound diagnosis were correlated.Results: 100 cases of first trimester bleeding evaluated by Ultrasonography with an incidence 2.37%. Most common cause was abortion (81.6%) then molar (10%) and ectopic pregnancy (9%). Out of 100 cases, 72 cases confirmed, 28 cases proved by ultrasound which was misdiagnosed on clinical examination with disparity of 72 between clinical and ultrasound diagnosis. 13 cases viable pregnancy by ultrasonography with sensitivity, specificity, NPV and PPV of 100% and 69 cases nonviable pregnancies with sensitivity, specificity and NPV of 100%. 9 cases ectopic pregnancy were diagnosed on ultrasound with sensitivity 100%, specificity 98.9%, PPV 99% and accuracy 99%. Clinical diagnosis in diagnosing viable pregnancies has sensitivity 76.92%, specificity 64.36% and PPV 24.39%. In diagnosis nonviable pregnancies, clinical diagnosis, poor statistical correlation with sensitivity 77.58, specificity 83.33%, PPV 86.53% and NPV 72.91%. Ultrasonographic diagnosis proved as very accurate on statistical correlation.Conclusions: Ultrasound is sensitive, cost effective and non-invasive diagnostic tool in first trimester bleeding. In this study, it helped in correct diagnosis of clinically misdiagnosed cases apart from confirming the diagnosis in others.

SIGNIFICANCE OF ULTRASOUND IN CLINICALLY DIAGNOSED CAUSES OF VAGINAL BLEEDING IN FIRST TRIMESTER PREGNANCY

2021 ◽  
pp. 74-75
Author(s):  
Amit Shankhwar ◽  
Prem Siddharth Tripathi ◽  
Saurabh Atram ◽  
Pankaj Kujur ◽  
Prakhar Nigam ◽  
...  
Keyword(s):  
Clinical Diagnosis ◽  
Vaginal Bleeding ◽  
Imaging Modality ◽  
First Trimester ◽  
First Trimester Pregnancy ◽  
Incomplete Abortion ◽  
Trimester Pregnancy ◽  
Highly Sensitive ◽  
History Of ◽  
Threatened Abortion

Background: (1) Nearly one-fourth (20-25%) of all pregnant women present with history of vaginal bleeding during the rst trimester . Ultrasound imaging plays an important role in determining the causes of vaginal bleeding during rst trimester of pregnancy. Aims & Objectives:To evaluate the signicance of ultrasound in clinically diagnosed causes of vaginal bleeding in rst trimester pregnancy. Methods: 100 women with vaginal bleeding during rst trimester of pregnancy with clinical diagnosis were evaluated by ultrasonography [USG] and interpretation was compared. Results: Among these 100 cases, threatened abortion was the commonest cause of bleeding (30%) followed by incomplete abortion. Disparity was found between clinical diagnosis of rst trimester vaginal bleed and ultrasound diagnosis. Ultrasound is highly sensitive and specic in diagnosing all causes of rst trimester vaginal bleed including ectopic pregnancy. Conclusion: With good diagnostic performance, USG proves to be an important imaging modality in determining the causes of vaginal bleeding during rst trimester of pregnancy and thus provides an aid for clinicians in better management of patients.

SIGNIFICANCE OF ULTRASOUND IN CLINICALLY DIAGNOSED CAUSES OF VAGINAL BLEEDING IN FIRST TRIMESTER PREGNANCY

2021 ◽  
pp. 39-40
Author(s):  
Amit Shankhwar ◽  
Prem Siddharth Tripathi ◽  
Saurabh Atram ◽  
Pankaj Kujur ◽  
Prakhar Nigam ◽  
...  
Keyword(s):  
Clinical Diagnosis ◽  
Vaginal Bleeding ◽  
Imaging Modality ◽  
First Trimester ◽  
First Trimester Pregnancy ◽  
Incomplete Abortion ◽  
Trimester Pregnancy ◽  
Highly Sensitive ◽  
History Of ◽  
Threatened Abortion

Background: Nearly one-fourth (20-25%) of all pregnant women present with history of vaginal bleeding during the rst trimester (1). Ultrasound imaging plays an important role in determining the causes of vaginal bleeding during rst trimester of pregnancy. Aims & Objectives: To evaluate the signicance of ultrasound in clinically diagnosed causes of vaginal bleeding in rst trimester pregnancy. Methods: 100 women with vaginal bleeding during rst trimester of pregnancy with clinical diagnosis were evaluated by ultrasonography [USG] and interpretation was compared. Results: Among these 100 cases, threatened abortion was the commonest cause of bleeding (30%) followed by incomplete abortion. Disparity was found between clinical diagnosis of rst trimester vaginal bleed and ultrasound diagnosis. Ultrasound is highly sensitive and specic in diagnosing all causes of rst trimester vaginal bleed including ectopic pregnancy. Conclusion: With good diagnostic performance, USG proves to be an important imaging modality in determining the causes of vaginal bleeding during rst trimester of pregnancy and thus provides an aid for clinicians in better management of patients.

scholarly journals Pregnancy outcome in women presenting with per vaginal bleeding in first trimester of pregnancy

2021 ◽  
Vol 10 (2) ◽  
pp. 439
Author(s):  
Aisha Moon ◽  
Saima Shabbir
Keyword(s):  
Vaginal Bleeding ◽  
Placenta Previa ◽  
Tertiary Care ◽  
First Trimester ◽  
Fetal Outcome ◽  
Care Hospital ◽  
Wide Range ◽  
Life Threatening ◽  
Red Flag ◽  
First Trimester Of Pregnancy

Background: Approximately 16%-25% of pregnancies are complicated by first trimester bleeding. The wide range of causes of early pregnancy bleeding, threat to loss the pregnancy and fear of having any life threatening cause puts pregnant female with first trimester bleeding into the state of uncertainty which leads to anxiety and depression. The objective of this study was to determine fetal outcome in women presenting with per vaginal bleeding in first trimester of pregnancy.Methods: This prospective observational study was carried out on 75 women presenting with complain of first trimester bleeding at Kulsumbai Valika hospital, a tertiary care hospital located in SITE area Karachi, Pakistan from July 2019 to July 2020 for a period of 1 year. A Performa was designed to collect information and patient followed until pregnancy is terminated.Results: The majority of participants presented at 8th week of gestation. Out of 75 participants who presented with first trimester bleeding 40% ended up in miscarriage. 6% had ectopic, 2% had molar pregnancy, 4% had placenta previa, 6% had preterm birth and 40% had healthy infant at the end of pregnancy.Conclusions: Bleeding in pregnancy is a red flag sign and needs to be addressed with wise approach to have optimal possible maternal and fetal outcomes.

scholarly journals Axial torsion of Meckel’s diverticulum causing acute peritonitis in the first trimester of pregnancy: a case report

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Hiromitsu Nagata ◽  
Hiroyasu Nishizawa ◽  
Susumu Mashima ◽  
Yasuyuki Shimahara
Keyword(s):  
Clinical Diagnosis ◽  
Meckel’S Diverticulum ◽  
Ileocecal Valve ◽  
First Trimester ◽  
Meckel's Diverticulum ◽  
Ileocecal Resection ◽  
Bowel Loop ◽  
Axial Torsion ◽  
First Trimester Of Pregnancy ◽  
In Pregnancy

Abstract Background Meckel’s diverticulum is considered the most prevalent congenital anomaly of the gastrointestinal tract. Approximately 4% of patients are symptomatic with complications such as bleeding, intestinal obstruction, and inflammation, while axial torsion of Meckel’s diverticulum is rare, particularly in pregnancy. Case presentation A 31-year-old woman in week 15 of pregnancy complained of epigastric pain, nausea and vomiting. Clinical diagnosis was severe hyperemesis gravidarum. Because the symptoms persisted during hospitalization, CT was performed and revealed dilated small bowel loops with multiple air-fluid levels. In the right mid-abdomen, there was a large part of air containing a cavity connected to the small intestine, which was considered a dilated bowel loop. Emergency laparotomy was performed and axial torsion of a large Meckel’s diverticulum measuring 11 cm was found at a few centimeters proximal to the ileocecal valve. Ileocecal resection including Meckel’s diverticulum was performed. The postoperative course was uneventful. At 40 weeks gestation, she had vaginal delivery of normal baby. Conclusion The physiological and anatomical changes in pregnancy can make a straightforward clinical diagnosis difficult. Prompt diagnosis and management were needed in order to avoid significant maternal and fetal risks. The use of imaging examinations, especially CT examination, with proper timing may be helpful to prevent delay in diagnosis and surgical intervention. Here, we report the case of a patient with axial torsion of Meckel’s diverticulum in pregnancy. To our knowledge, axial torsion of Meckel’s diverticulum in the first trimester of pregnancy has not been reported in the English medical literature.

scholarly journals Spontaneous rupture of an unscarred uterus in early pregnancy: a rare but life-threatening emergency

2019 ◽  
Vol 12 (5) ◽  
pp. e228493 ◽  
Author(s):  
Bedayah Amro ◽  
Ghassan Lotfi
Keyword(s):  
Early Pregnancy ◽  
Uterine Rupture ◽  
Laparoscopic Approach ◽  
First Trimester ◽  
Rare Occurrence ◽  
Spontaneous Uterine Rupture ◽  
First Case ◽  
Life Threatening ◽  
First Trimester Of Pregnancy ◽  
Underlying Risk

Spontaneous uterine rupture during early pregnancy is an extremely rare occurrence and may vary in presentation and course of events, hence the clinical diagnosis is often challenging. We present our experience with two such cases of spontaneous uterine rupture in the first trimester of pregnancy without any identifiable underlying risk factors. The first case was at 12 weeks of gestation and the second case was at 6 weeks gestational age (GA). Both cases were diagnosed and managed by the laparoscopic approach. We are reporting the earliest documented GA in which spontaneous uterine rupture occurred. So far, the earliest GA reported in the literature according to our knowledge was at 7+3 weeks. Access to a laparoscopic facility is crucial in the early definitive diagnosis and prompt management of these cases, since this may significantly reduce the risk of severe morbidity and mortality.

scholarly journals Chronic Tubal Ectopic Pregnancy with Diagnostic Conundrum: A Case Report

2021 ◽  
Vol 6 (2) ◽  
pp. 192-194
Author(s):  
Vishal Sharma ◽  
Ravi Dutt Wadhwa
Keyword(s):  
Case Report ◽  
Ectopic Pregnancy ◽  
Gestational Age ◽  
First Trimester ◽  
Present Case Report ◽  
Tubal Ectopic Pregnancy ◽  
Threatening Condition ◽  
Life Threatening ◽  
First Trimester Of Pregnancy ◽  
Ectopic Pregnancies

Ectopic pregnancy is a life threatening condition and mostly ectopic pregnancies occurs in fallopian tube. The most common site of ectopic tubal pregnancy is ampulla. Ectopic pregnancy is a complication of pregnancy and usually easy to diagnose by ultrasonography during the first trimester of pregnancy. Due to limited healthcare resources in developing countries, women do not undergo for ultrasound examination during pregnancy which leads to late diagnosis. In most of cases women with ectopic pregnancy are asymptomatic, unless ruptured. The mean gestational age for clinical presentation of ectopic pregnancy is 7.2 weeks after the last normal menstrual period. In rural population, late presentations of ectopic pregnancies are more commonly seen because of lack of modern diagnostic ability. Present case report is a rare case of non-viable, unruptured, tubal ampullary chronic ectopic pregnancy of 12 weeks gestational age. Keywords: Ectopic pregnancy, Unruptured, gestational age, ultrasonography.

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