Abstract

Bleeding per vaginum in the first trimester occurs in 15-25 % of all pregnancies with 50% pregnancy loss. The significance of bleeding in early pregnancy may vary in presentation from simple implantation bleeding to life threatening emergency like ectopic or molar pregnancy. This bleeding might be associated with subchorionic hemorrhage or hematoma which in turn will effect the maternal and perinatal outcome. To identify the cause of vaginal bleeding in first trimester and to evaluate the maternal and perinatal outcome of first trimester bleeding per vaginum; To discuss the role of ultrasound in pregnancy outcome of first trimester bleeding per vaginum. Methods: This is a Prospective observational study which included obstetric cases with history of bleeding per vaginum in first trimester of pregnancy, who give informed consent for the study during the period of May 2022 to March 2023, who were selected by systematic randomization method. A detailed history was taken, clinical examination including complete general physical examination and local examination was done to arrive at a provisional clinical diagnosis which followed by an ultrasound examination. Maternal and perinatal outcome was then assessed in terms of the maternal and perinatal outcome. Results: In 95 cases of first trimester bleeding, there were 16 first trimester miscarriage, 4 second trimester miscarriage and 75 pregnancies proceeded to the period of viability. Preterm births were 13, full term were 62. Out of all, 6 underwent caesarean section and 56 patients delivered vaginally, 3 instrumental deliveries and 1 breech extraction. Total of 1 perinatal mortality due to birth asphyxia. Conclusion: To conclude that early diagnosis, bed rest and regular antenatal follow-up will help in continuing the pregnancy till term with good maternal and fetal outcome. Ultrasound being a sensitive, cost effective and most important non-invasive diagnostic tool, helped in confirming the clinical diagnosis and instituting appropriate treatment.

Description