Sonographic findings in first trimester vaginal bleeding at Moi teaching and referral hospital

Abstract

Background: First trimester per vaginal bleeding may be an indication of early pregnancy failure. Clinical management relies on sonography with delay or inadequate diagnosis leading to pregnancy loss or maternal mortality. Objective: To describe the ultrasound findings in patients referred with first trimester bleeding in relation to their clinical characteristics. Methods: This was a cross-sectional study. A total of 201 women who had first trimester vaginal bleeding were recruited. Study was done at Moi Teaching and Referral hospital (MTRH), between November 2015 and October 2016. Associations were assessed using Fisher’s exact test and results were presented in tables and graphs. Results: Median age was 27.0 years. The most common Ultrasound findings were incomplete abortion (22.9%), Uterine Fibroids in Pregnancy was diagnosed in (15.4%) and Extra uterine Pregnancy (14.4%). Significant clinical association were; Complete and incomplete abortion was associated with prolonged and heavy bleeding (p = 0.003 and <0.001 respectively). Majority diagnosed with incomplete abortion had no history of contraceptive use (p = 0.003). Anembryonic pregnancy was associated with spotting (p = 0.008). Diagnosis of extra uterine pregnancy was associated with spotting. Conclusion: Incomplete abortion, uterine fibroids in pregnancy and ectopic pregnancy were common sonographic findings. Ectopic pregnancy was associated with previous history of contraceptive use.