Ultrasonic Assessment of The First Trimester Vaginal Bleedingin Duhok City / Kurdistan Region of Iraq

Abstract

First trimester vaginal bleeding has been considered as one of the commonest obstetrical and gynecological emergencies estimated in 20-25 % of all obstetrical emergencies all over the world. The aim of this study was the use of ultrasonic (US) imaging to identify the commonestcauses of first trimester vaginal bleeding , finding their incidence in primigravida and multigravida pregnant women , detecting the most frequent mean age of occurrence according to gestational age in weeks , looking for the incidence of viable and nonviable pregnancy among them , detecting their relations with a bad obstetrical history and finally estimating the disparity between clinical and ultrasonic diagnosis . Patients and Methods: This study is a cross sectional study that has been done on one hundred thirteen pregnant women presented with vaginal bleeding in their first trimester of pregnancy, attending Azadi Teaching Hospital and Duhok Maternity Hospital from 1stJune to 22th of November (2019 ). All patients were clinically referred byspecialized clinicians and subjected to ultrasound examination and examined under supervision of specialized radiologists. Results: The mean age of the examined patients was29.4±5.9 years, multigravida were more than primigravida constituting (81.4%) of the cases compared with the primigravidawhich constituted (18.6%) of the cases , regarding the gestational age of these referred cases most of them were between 6-8 weeks of gestational Age (GA) with the mean 8.2±1.6 weeks. The prevalence ofnon-viable pregnancy constituting (67.3%) and the most common cause of vaginal bleeding was miscarriage (84.1%). The next frequent reason was ectopic pregnancy (6.2%) subsequently hydatiformmole (3.5%). The most common subtype of miscarriage was threatened miscarriage (32.7%). Among all the patients, thewhole difference between ultrasound diagnosis and medical diagnosis were found in 72 patients. Consequently, (63%) wasthe whole accurateness of clinical diagnosis while ultrasound accuracy was (100%). Conclusion: Ultrasound examination for the cases who are complaining from the first trimester vaginal bleeding ishelpful in confirming and detecting the different causes behind this bleeding,in addition to allow an early detection and more confident early obstetrical management with less subsequent complications