International Journal of Clinical Obstetrics and Gynaecology

Background: Bleeding per vaginum in early pregnancy is a common presentation in the emergency room. Approximately 20-25% of pregnant women can have bleeding during early pregnancy. 50% of women who have vaginal bleeding in the first trimester of pregnancy will continue to have a viable pregnancy. About 50% of first Trimester bleeding will lead to miscarriage. Considering these factors, we attempted to evaluate the role of ultrasonography in the diagnosis of bleeding per vaginum during pregnancy & its correlation with clinical findings.

Aims and Objectives: To establish the fundamental role of ultrasonography in first trimester vaginal bleeding and to avoid premature interventions in a putatively nonviable pregnancy where early intervention might lead to misdiagnosis and mismanagement

Methods and Materials: This prospective observational study was conducted among all the antenatal women with first trimester vaginal bleeding attending ante-natal clinic & emergency labour room who met the inclusion and exclusion criteria in Department of Obstetrics & Gynecology, Ruby Hall Clinic, Pune during the period May 2017 to April 2018.

Results: The mean ± SD of age of the entire group of cases studied was 26.9 ± 3.9 years and the minimum to maximum age range was 19 – 38 years. On clinical examination, out of 180 cases, 71.1% were threatened abortion, 10% as incomplete abortion, 8.9% missed abortion, and 4.4% complete abortion, 2.8% normal pregnancy, 1.7 % ectopic and 1.1 % hydatidiform mole. Ultrasonography in 180 cases of first trimester vaginal bleeding are viable pregnancy was seen in 105 (58.33%) cases, non-viable pregnancy in 67 cases, 6 cases of ectopic gestation and 2 cases of hydatidiform mole.

Conclusions: Ultrasonography is accurate safe and non-invasive diagnostic tool in differentiating various conditions of first trimester bleeding. Prompt treatment based on the ultrasound findings, not only reduces the maternal morbidity and mortality but also helps in less hospital stay and alleviates anxiety among the couples.