Ultrasonographic evaluation of first trimester bleeding per vaginum

Gupta, Neelam; Samariya, Meenakshi; Choudhary, Devika; Yadav, Kanti; Kannoujiya, Pushpa

doi:10.18203/2320-1770.ijrcog20162990

Cited by 9 publications

(16 citation statements)

References 2 publications

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“…Threatened abortion (47.5%) was the commonest cause of first trimester vaginal bleeding. This similar trend was observed in other studies [11][12][13] . The clinical diagnosis of threatened abortion is presumed when bleeding occurs through closed cervical os before 20 weeks of gestation 1 .…”

Section: Discussionsupporting

confidence: 92%

Observational Study of Patients Presenting with Bleeding in First Trimester

2020

IJFMT

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Objective: First trimester is an important period during which there is risk of bleeding and may lead to spontaneous abortion. More than 80% spontaneous abortions occur in first trimester. The aim of this study was to determine the causes of first trimester bleeding.Method: This was a cross sectional descriptive study conducted at Shalinitai Meghe hospital and Research centre Hingana, Nagpur during January 2020 to June 2020. The patients presenting to OPD with history of bleeding or spotting per vaginum, positive urine pregnancy test and less than 12 weeks of gestation were included in this study. Clinical examination and ultrasonography was done.Result: Most of the patients presented with moderate bleeding and associated pain. The duration of bleeding was 2 to 5 days. Majority of cases were between 4-8 weeks (69.5%). History of prior miscarriage was present in 23.7%. 61% of cases were anemic. Threatened abortion was most common in patients presenting with bleeding per vaginum (in 47.5%). 18.6% patients were with incomplete abortion and 11.8% had complete abortion. There were 2 cases of unruptured ectopic pregnancy and 1 case of ruptured ectopic pregnancy. Salpingectomy was done in all the 3. Dilatation and evacuation was done in 12 cases. Gestational sac was present in 52 cases and the appearance was normal in 53.8% cases. Yolk sac was present in 65.4% cases. Fetal pole and cardiac activity was seen in 57.7%cases. Conclusion:Bleeding in first trimester of pregnancy is the common complaint with which the pregnant women presents to the health care worker. The commonest cause is the threatened abortion. Other causes are incomplete, complete and missed abortions. Bleeding in early pregnancy may be early presentation of a serious situation like ectopic pregnancy. Ultrasonography, especially the Trans Vaginal is very important in concluding the causes of bleeding. Pregnant women should be educated in the first visit to antenatal OPD itself for the symptoms like bleeding per vaginum and to seek help from health care worker as soon as possible.

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Section: Discussionsupporting

confidence: 92%

Observational Study of Patients Presenting with Bleeding in First Trimester

2020

IJFMT

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“…Ultrasonography examination findings.USG DiagnosisGupta N et al[2] Aronu et al[3] Priso B et al[4] Present study…”

mentioning

confidence: 94%

“…Spotting is the most common cause of bleeding caused by implantation of the conceptus into the endometrium. The occurrence of first trimester bleeding per vaginum is estimated to be as high as 7% to 24% in early pregnancies [2]. About 50% of first Trimester bleeding lead to miscarriage; the primary causes of first trimester bleeding are spontaneous abortions, ectopic pregnancies, and gestational trophoblastic diseases [3].…”

Section: Introductionmentioning

confidence: 99%

“…Clinical history and pelvic examination are often inadequate in assessing the cause and the prognosis. When ultrasonography reveals the nature of the pregnancy (viable/non-viable), unnecessary complications and misdiagnosis in first trimester bleeding can be avoided [2]. But the unavailability of ultrasound devices and trained practitioners limit the use of this exam.…”

Section: Introductionmentioning

confidence: 99%

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Ultrasound Study of First Trimester Bleeding

Guena¹,

Alapha²,

Kemegne³

et al. 2019

OJRad

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Objective: Bleeding during the first trimester of pregnancy is common and can be a sign of complication that often necessitates obstetric ultrasound for the assessment of the haemorrhage, and of fetal well being. The aim of this study was to determine the causes of first trimester bleeding on obstetrical ultrasound in our area. Method: It was a cross-sectional descriptive study during a six-month period from May to October 2017. All women who referred to the Regional center of medical imaging of Ngaoundere who agreed to participate in the study with first trimester bleeding were evaluated with clinical history and ultrasonography (US). Ultrasonographic exam was done via transabdominal or endovaginal approaches using GE LOGIQ 7 scanner brand. Microsoft Office Excel 2010 and SPHINX V 4.0 were used for data analysis. Results: A total of 121 of pregnant women who presented vaginal bleeding during the first trimester were enrolled into the study. These Ultrasound examinations represented 37.93% of all obstetric ultrasounds in the first trimester. The patients in this study ranged in age from 16 to 47 years with an average of 30 years. 50 (41.32%) were pregnant for the first time and 24 (19.83%) were primiparous. Mean gestational age was 9 weeks with the extremes of 5 and 12 weeks. 97 (80.2%) reported spontaneous bleeding while in 24 (18.8%) bleeding was mostly caused by sexual intercourse 11 (45.8%). Pelvic pain 91 (75.2%) was the most associated sign. 36 (29.8%) patients were diagnosed as threatened abortions. 27 (22.3%) were diagnosed with incomplete abortions. 4 (3.3%) cases showed an ectopic gestation. 9 (7.4%) cases showed complete abortions. Concordance between clinical diagnosis and ultrasound results was 84%. Conclusions: Bleeding in the first trimester of pregnancy is common in our area. Ultrasonography occupies a prominent place in the etiological diagnosis of bleeding in the first trimester of pregnancy;

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“…aginal Bleeding (VB) has been considered the commonest cause of emergency conditions in the first trimester of pregnancy , usually seen in the emergency departments of the maternity hospitals , accounting 20-25% of the emergency cases during this period of pregnancy in the world , therefore, early detection and proper diagnosis are essential for proper management , as it is also essential for diagnosing the mostcommon causes of natural miscarriage which take place around 15% globally in this trimester of pregnancy ( ( Singh.K 2016, Gupta ,et al 2016 Using ultrasound (US) imaging plays a major role in evaluation of first trimester VB as it is not accompanied by any reportable side effects with the use of proper suitable probes frequencies ,3-5 MHz transabdominal ultrasound (TAU) and 5-7 MHz transvaginal ultrasound (TVU). The accurate diagnosis of the viable or non-viable pregnancy using ultrasound imaging prevents unnecessary prolonged hospitalization, hormonal treatment or unnecessary curettage to the patients.…”

Section: Introductionmentioning

confidence: 99%

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

Saeed

Mohammed²,

Ali³

2022

UOD

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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

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Ultrasonographic evaluation of first trimester bleeding per vaginum

Cited by 9 publications

References 2 publications

Observational Study of Patients Presenting with Bleeding in First Trimester

Observational Study of Patients Presenting with Bleeding in First Trimester

Ultrasound Study of First Trimester Bleeding

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

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