scholarly journals AN ASSESSMENT INTO THE DIAGNOSTIC VALUE OF ULTRASOUND IN THE FIRST TRIMESTER OF PREGNANCY BLEEDING

2021 ◽  
Vol 5 (9) ◽  
Author(s):  
Tarak Nath Mukherjee
Keyword(s):  
Clinical Evaluation ◽  
Diagnostic Tool ◽  
Vaginal Bleeding ◽  
First Trimester ◽  
Diagnostic Value ◽  
Statistical Correlation ◽  
Pregnant Female ◽  
Ultra Sound ◽  
Intrauterine Pregnancy ◽  
Threatened Abortion

Background: One of the most prevalent obstetric issues is vaginal bleeding in the first trimester. It's also one of the most prevalent reasons for emergency admissions, as well as a reason for ultra-sound evaluation in the first trimester. In the first trimester, over a quarter of all pregnant female experience bleeding. Aims and objective: The purpose of this research was to determine the diagnostic value of ultra-sonography in first-trimester haemorrhage. Materials and method: All pregnant female who experienced per vaginal bleeding during the first trimester were included in this research. A semi-structured questionnaire was used to assess all of the selected instances. To arrive at a clinical opinion, a full history and comprehensive clinical evaluation were undertaken, including general, systemic, per abdominal, and per vaginal evaluations. In all of the cases that were chosen, ultra-sonography was used. The results of the clinical evaluation and ultra-sonography were documented. Results: On clinical evaluation, 164 cases of threatened abortion were identified, whereas ultra-sonography verified 102 cases of impending abortion. In 62 cases, there was a discrepancy in opinion. Complete abortion had a 16 percent inconsistancy, while incomplete abortion had a 4 percent inconsistancy. In 20 cases of Blighted ovum, there was a inconsistancy. Out of 214 occurrences of first trimester bleeding, abortion was diagnosed in 200 cases (93.46 percent), ectopic pregnancy in 10 cases (4.67 percent), and hydatiform mole in four cases (1.87 percent). Clinical opinion had a 100% sensitivity in diagnosing a viable intrauterine pregnancy, but only a 44.6 percent specificity. Clinical opinion has a poor statistical correlation in diagnosing nonviable pregnancies, with a sensitivity of 39%. Conclusion: Ultra-sonography has thus been established as a critical diagnostic tool in obstetrics. It is a readily available diagnostic tool that aids in the early detection of problems associated with first-trimester haemorrhage. It was established in the aforementioned research that it had an essential role in the opinion of first trimester haemorrhage. Key Word: first trimester bleeding, ultasonography, diagnostic importance

scholarly journals Female with Vaginal Bleeding

2020 ◽  
Vol 4 (4) ◽  
pp. 636-637
Author(s):  
Mark Quilon ◽  
Alec Glucksman ◽  
Gregory Emmanuel ◽  
Josh Greenstein ◽  
Barry Hahn
Keyword(s):  
Emergency Department ◽  
Emergency Physician ◽  
Vaginal Bleeding ◽  
Point Of Care ◽  
First Trimester ◽  
Yolk Sac ◽  
Pregnant Female ◽  
Point Of Care Ultrasound ◽  
Fetal Demise ◽  
Case Presentation

Case Presentation: A 24-year-old pregnant female presented to the emergency department with lower abdominal cramping and vaginal bleeding. A point-of-care ultrasound demonstrated a calcified yolk sac. Discussion: When identified, calcification of the yolk sac in the first trimester is a sign of fetal demise. It is important for an emergency physician to be aware of the various signs and findings on point-of-care ultrasound and be familiar with the management of these pathologies.

scholarly journals Ruptured Ectopic Pregnancy in the Presence of an Intrauterine Device

2019 ◽  
Vol 3 (1) ◽  
pp. 51-54 ◽  
Author(s):  
Matthew Neth ◽  
Maxwell Thompson ◽  
Courtney Gibson ◽  
John Gullett ◽  
David Pigott
Keyword(s):  
Abdominal Pain ◽  
Maternal Mortality ◽  
Ectopic Pregnancy ◽  
Female Patient ◽  
Vaginal Bleeding ◽  
Intrauterine Device ◽  
First Trimester ◽  
Equal Protection ◽  
Intrauterine Pregnancy

Ruptured ectopic pregnancy is the leading cause of first trimester maternal mortality. The diagnosis of ectopic pregnancy should always be suspected in patients with abdominal pain, vaginal bleeding or syncope. While the use of an intrauterine device (IUD) markedly reduces the incidence of intrauterine pregnancy, it does not confer equal protection from the risk of ectopic pregnancy. In this report we discuss the case of a female patient who presented with a ruptured ectopic pregnancy and hemoperitoneum despite a correctly positioned IUD.

scholarly journals Different Sonographic Faces of Ectopic Pregnancy

2017 ◽  
Vol 7 ◽  
pp. 6 ◽  
Author(s):  
Charu Chanana ◽  
Nishant Gupta ◽  
Itisha Bansal ◽  
Kusum Hooda ◽  
Pranav Sharma ◽  
...  
Keyword(s):  
Ectopic Pregnancy ◽  
Chorionic Gonadotropin ◽  
Vaginal Bleeding ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
First Trimester ◽  
Intrauterine Pregnancy ◽  
Pictorial Essay ◽  
History Of ◽  
Clinical Signs And Symptoms

Vaginal bleeding in the first trimester has wide differential diagnoses, the most common being a normal early intrauterine pregnancy, with other potential causes including spontaneous abortion and ectopic pregnancy. The incidence of ectopic pregnancy is approximately 2% of all reported pregnancies and is one of the leading causes of maternal mortality worldwide. Clinical signs and symptoms of ectopic pregnancy are often nonspecific. History of pelvic pain with bleeding and positive β-human chorionic gonadotropin should raise the possibility of ectopic pregnancy. Knowledge of the different locations of ectopic pregnancy is of utmost importance, in which ultrasound imaging plays a crucial role. This pictorial essay depicts sonographic findings and essential pitfalls in diagnosing ectopic pregnancy.

scholarly journals Ruptured Tubal Ectopic Pregnancy at Fifteen Weeks Gestational Age

2019 ◽  
Vol 3 (1) ◽  
pp. 62-64 ◽  
Author(s):  
Justine Stremick ◽  
Kyle Couperus ◽  
Simeon Ashworth
Keyword(s):  
Abdominal Pain ◽  
Ectopic Pregnancy ◽  
Gestational Age ◽  
Vaginal Bleeding ◽  
First Trimester ◽  
Second Trimester ◽  
Intrauterine Pregnancy ◽  
Tubal Ectopic Pregnancy ◽  
Ectopic Pregnancies ◽  
First Trimester Ultrasound

Tubal ectopic pregnancies are commonly diagnosed during the first trimester. Here we present a second-trimester tubal ectopic pregnancy that was previously misdiagnosed as an intrauterine pregnancy on a first-trimester ultrasound. A 39-year-old gravida 1 para 0 woman at 15 weeks gestation presented with 10 days of progressive, severe abdominal pain, along with vaginal bleeding and intermittent vomiting for two months. She was ultimately found to have a ruptured left tubal ectopic pregnancy. Second-trimester ectopic pregnancies carry a significant maternal mortality risk. Even with the use of ultrasound, they are difficult to diagnose and present unique diagnostic challenges.

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.

scholarly journals A study of feto-maternal outcome in bleeding per vaginum in first trimester of pregnancy

2020 ◽  
Vol 9 (3) ◽  
pp. 1191
Author(s):  
Jaydeep J. Bhatu ◽  
Darshil S. Prajapati
Keyword(s):  
Vaginal Bleeding ◽  
Local Population ◽  
Previous History ◽  
Perinatal Outcomes ◽  
First Trimester ◽  
Maternal Complications ◽  
History Of ◽  
Threatened Abortion ◽  
Degree Of Association ◽  
In Pregnancy

Background: Bleeding per vaginum in the first trimester is a common obstetric entity. Four major causes of pathological bleeding in 1st trimester are miscarriage, ectopic pregnancy, implantation bleeding of pregnancy and cervical pathology. The purpose of this study was to investigate and understand the effect of first trimester vaginal bleeding on maternal and perinatal outcomes in the local population to which our hospital serves. Objective of this study was to estimate the degree of association between first-trimester bleeding and miscarriage, pregnancy outcomes in women with threatened abortion, various maternal complications and outcome of labor in pregnancy complicated by first-trimester bleeding and adverse fetal outcomes affected with first trimester bleeding.Methods: This prospective observational study was carried out on 110 women attending hospital with history of first trimester vaginal bleeding at a tertiary health center - sola civil hospital Ahmedabad for a period of twelve months.Results: Majority (69%) of first trimester bleeding occurs in age group of 21-30 years and majority of patients were primigravida constituting 53% out of 110 patients, 48 patients presented with abortions, out of which 26 had threatened abortion and 22 had other abortions. Primi para with previous history of bleeding per vaginum had more chances to go in full term in present pregnancy.Conclusions: Patients presenting with heavy bleeding per vaginum ended up in pregnancy loss and thus a poor outcome. In the presence of sub-chorionic hematoma, the prognosis of pregnancy is greatly affected as the risk of pre-term, IUGR and especially miscarriages increase significantly.

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.

Early pregnancy and pelvic ultrasound

2019 ◽  
pp. 107-116
Author(s):  
Ryan Henneberry ◽  
Chris Cox ◽  
Beatrice Hoffmann ◽  
Paul Atkinson
Keyword(s):  
Abdominal Pain ◽  
Early Pregnancy ◽  
Vaginal Bleeding ◽  
Point Of Care ◽  
First Trimester ◽  
Clinical Findings ◽  
Point Of Care Ultrasound ◽  
Clinical Parameters ◽  
Intrauterine Pregnancy ◽  
First Trimester Pregnancy

Point-of-care ultrasound (PoCUS) has an important role in the management of vaginal bleeding and/or abdominal pain in early pregnancy. When combined with other clinical parameters, PoCUS enables the treating physician to accurately confirm the presence of an early intrauterine pregnancy (IUP). This chapter provides a suggested algorithm for the use of bedside ultrasound and clinical findings to safely assess patients with first-trimester pregnancy pain or bleeding and rule out an ectopic pregnancy. Both trans-abdominal and trans-vaginal approaches are described in detail.

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

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