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 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 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 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 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.

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