Abstract:
Background :
First trimester vaginal bleeding is a common condition, occurring in
approximately 16 – 20 % of pregnant women.
The important causes of first trimester bleeding include inevitable abortion,
missed abortion, incomplete abortion, complete abortion, molar pregnancy, ectopic
pregnancy, implantation bleeding, subchorionic bleeding and threatened abortion. Some
of the above mentioned conditions are absolute indications for termination of pregnancy
which can be missed by clinical diagnosis alone. Ultrasonography aids in diagnosing
these conditions accurately.
Objective:
To evaluate the causes and complications of first trimester bleeding and to
identify high risk pregnancy which warrants termination of pregnancy .
Method:
It is a randomized prospective study conducted in 128 pregnant women < 12 weeks of
Gestation with bleeding PV attending DEPT. of OBG of Shri. B.M.Patil medical college
BLDE university, Bijapur.
After taking in to consideration the inclusion and exclusion criteria, all 128 patients were
included into the study and subjected to ultrasound examination.
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Results:
In our study of 128 cases, 40 cases were threatened abortion, 20 cases were complete
abortion, 15 cases were missed abortion, 15 cases were inomplete abortion, 14 cases were
inevitable abortion, 3 cases were blighted ovun, 8 cases were ectopic pregnancy and 6
cases were molar pregnancy. In these 128 cases, 93 ended in pregnancy failure. In 40
cases of threatened abortion, 21 cases had full term normal delivery, 7 cases had pre term
delivery, 2 cases had spontanious abortion, 3 cases underwent mtp with tubectomy and 7
cases lost follow up .
The diagnosis by ultrasound wad done in all cases except in 2 cases, one is molar
pregnancy which was diagnosed by HPR. Other one was ectopic pregnancy, diagnosed
during laparotomy. The diagnostic accuracy of ultrasound in this study is 98.5%.
Conclusion:
Ultrasound is safe, non invasive and accurate method of diagnosis in first
trimester bleeding and its outcome.
