To Evaluate the causes of Bleeding per Vagina in first Trimester of Pregnancy by Ultrasonography

Abstract

Background &Method: This prospective study was done in the Department of Radiodiagnosis & Obstetrics and Gynaecology of Mahatma Gandhi Medical College & M.Y. Hospital, Indore, Madhya Pradesh, India after getting approval by ISRB (Institutional Scientific Review Board).A total of 100 patients who were referred to our department with clinical history of positive urine pregnancy test and vaginal bleeding during first trimester of pregnancy from April 2019 to October 2020 after written consent and PCPNDT registration were assessed. Various causes of vaginal bleeding confirmed by transabdominal and transvaginal ultrasound and beta human chorionic gonadotropin testing aid was done.Result:Age ranged from 18 to 35 years which show that most of the patients belongs to age group of 21 to 25 years making 42%. 31(31%) patients belongs to 26 to 30 years, 15(15%) patients to 17 to 20 years and the least common age group was between 31 to 35 years constituting 12(12%) patients. The mean age group is 24.00 (SD= 3.16).On the basis of clinical diagnosis in patients with bleeding per vaginum during first trimester of pregnancy maximum 40(40%) patients were diagnosed as threatened abortion, while 17(17%) patients as incomplete abortion , 13(13%) patients as missed abortion , 11(11%) patients as complete abortion , 7(7%) patients as inevitable abortion, 6(6%) patients as molar pregnancy, 6(6%) patients as ectopic pregnancy.the study of 95 patients with intrauterine pregnancy showing G-sac in 62(65.26%) cases and was absent in 33(34.74%) cases. 44(46.31%) shows yolk sac and were absent in 51(53.68%). CRL was found 38(40%) and were absent in 57(60%). Cardiac activity was seen in 9(9.48%) patients and 86(90.52%) patients had absent cardiac activity.Conclusion:Vaginal bleeding in the first trimester of pregnancy is a common obstetric problem. Ultrasound has become a valuable aid in the diagnosis and prognosis of various causes of bleeding per vaginum in first trimester of pregnancy. Ultrasound positively helps in accessing the continuation of pregnancy, timely intervention for abnormal pregnancy and avoiding unnecessary intervention in those cases who do not need them. In the above study it was demonstrated that it played an important part in diagnosing the causes of vaginal bleeding during first trimester of pregnancy.