Clinical and ultrasound correlation in first trimester abortion

ABSTRACT

To compare the diagnostic accuracy of clinical and ultrasound evaluation in first trimester abortions and assess the impact of ultrasound on patient management. Non-interventional comparative study conducted on 100 patients, selected on simple random basis from Gynae Outpatient Department. Department of Obstetrics and Gynaecology, Allama Iqbal Medical College and Jinnah Hospital, Lahore Materials and All the patients with symptoms of first trimester abortion were evaluated clinically and by ultrasound to formulate a diagnostic and management plan. Both Modalities were compared for diagnostic accuracy, positive and negative correlation in different types of abortions. 34% of the patients were at 10 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. Ultrasonography is an essential tool in diagnosis of early pregnancy failures especially where clinical evaluation is inconclusive