Title: Need of Sonography in Vaginal Bleeding in Early Pregnancy; As a Primary Investigation
Authors: Jha Vandana, Panda Subrat, Sinha Anindita, Singh A Santa
DOI: https://dx.doi.org/10.18535/jmscr/v7i12.52
Abstract
Objective: Compare the diagnostic efficacy of ultrasound and clinical diagnosis in finding etiology of vaginal bleeding in early months of pregnancy.
Material and Methods: 104 cases of bleeding per vaginum during pregnancy upto 20th weeks were evaluated clinically and ultrasonography for one and half year. Diagnostic efficacy of both were analyzed statistically.
Result: Diagnostic accuracy of ultrasongraphy is 93.26% as compared to clinical accuracy of 56.73%. Ultrasound proved to be more accurate with a significant p value of < 0.5 in evaluating ectopic pregnancy. In cases of threatened abortion USG having better sensitivity and specificity than clinical diagnosis, but difference is significant for specificity only. USG can predict the prognosis of threatened by assessing risk factor. Specificity of USG is low in molar pregnancy than clinical diagnosis. In diagnosing early pregnancy failure comprises of blighted ovum, molar pregnancy, missed, incomplete, complete and inevitable abortion, USG having better sensitivity and specificity than clinical diagnosis with a significant p value of < 0.001.
Conclusion: Even in the era of technology Importance of history and clinical examination could never be negated, but the team approach with use of ultrasound not only improves the diagnostic accuracy, but also helps us to have a better and direct insight of pathophysiology of early pregnancy complication and better management.
Keywords: Abortion, blighted ovum, pregnancy, Ultrasound.
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