Asha Hanamshetty1, Sarita M. Hattarki2

ABSTRACT: OBJECTIVES: To evaluate the usefulness of ultrasound in the differential diagnosis of vaginal bleeding in the first trimester and to evaluate the management based on ultrasound diagnosis. METHODS: 75 women who attended the out-patient department with the complaint of bleeding per vagina in the first trimester pregnancy were taken a detailed history. Physical examination including pelvic examination was done and a provisional clinical diagnosis was made. In all cases routine investigations was done and then the patients were subjected to ultrasound examination. All the data was recorded in a proforma. RESULTS: Among these 75 cases, threatened abortion in 30 cases (40%) was the commonest cause for bleeding. There were 15 (20%) cases of missed abortion. In 8 (10.66%) cases of blighted ovum there were 4 (5.33%) cases of ectopic pregnancy. There were 3 cases of vesicular mole. The accuracy of ultrasound in diagnosing the cause of bleeding per vagina in the first trimester is 98%. CONCLUSION: In first trimester bleeding, the history and clinical findings, if totally relied upon can lead to delay in diagnosis. The diagnosis is instant and accurate so that unnecessary curettage was avoided with a consequent reduction in morbidity.