Clinical and ultrasound correlation in first trimester abortion
Keywords:Trimester, First. Abortion, Missed. Abortion, Induced. Abortion, Threatened. Pregnancy Trimester, Second. Ultrasonography, Prenatal. Gestational Age. Chorionic Villi Sampling. Abortion, Spontaneous.
Aims and Objectives of Study: To compare the diagnostic accuracy of clinical and ultrasound evaluation in first trimester abortions and assess the impact of ultrasound on patient management. Study Design: Non-interventional comparative study conducted o n 100 patients, selected o n simple random basis from Gynae Outpatient Department. Study place: Department of Obstetrics & Gynaecology, Allama Iqbal Medical College and Jinnah Hospital, Lahore Materials and Methods: All the patients with symptoms of first trimester abortion were evaluated clinically and by ultrasound to formulate a diagnostic and management plan. Main Outcome Measures: Both Modalities were compared for diagnostic accuracy, positive and negative correlation in different types of abortions. Results: 34% of the patients were at l0 weeks of gestation, 28% were unsure of dates, 17% were at 11 weeks of gestation, 13% of the patients were at 9 weeks of gestation, 5% were at 6 weeks while 3% were at 7 weeks of gestation. Clinical diagnosis was made in 42% of cases; in 39% definite diagnosis was possible with combined clinical and ultrasound evaluation while in 19% no diagnosis was established with either modality In 89% of the cases the diagnosis was made on single ultrasound scan, while 11% required a repeat scan. Correlation between two modalities was present in 81% of the cases. Positive correlation was obtained in 59% and negative correlation was seen in 22% . The correlation was not possible in 19% of cases. Conclusion: Ultrasonography is an essential tool in diagnosis of early pregnancy failures especially where clinical evaluation is inconclusive.
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