ROLE OF ULTRASOUND IN THE EVALUATION OF VAGINAL BLEEDING DURING PREGNANCY

Abstract

Vaginal bleeding is a common and serious complication during pregnancy. The differential diagnosis of such bleeding depends on the stage of gestation at which it occurs, and includes abortion, ectopic pregnancy, gestational trophoblastic disease, placental causes, other local causes and bleeding of unknown cause.

The role of diagnostic ultrasound in evaluating vaginal bleeding during pregnancy is, principally, for detecting possible causes of bleeding, detecting fetal life and for follow up of the cases later after their treatment. So, it should be considered the primary investigation for any pregnant woman presenting with bleeding.

The ultrasonography, including transabdominal' and endovaginal techniques are complimentary to each other. Endovaginal sonography has become the method of choice for the detection and evaluation of early pregnancy, as the proximity of the probe to the uterus produces impressively clear images of early pregnancy, most of the sonographic milestones used for assessment of early pregnancy can be established one week earlier with endovaginal sonography than with conventional transabdominal sonography. Also it has an advantage in that the bladder should not be fully distended which allows scanning nearly at the same time as clinical examination without delay.

Transvaginal sonography has a major role in evaluating patients with suspected ectopic pregnancy. Detecting small amounts of free fluid in the cul-de-sac or visualization of an extrauterine gestational sac. However, sometimes it only suspects presence of ectopic pregnancy and recommend