Ultrasonographic evaluation of first trimester bleeding

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