[Usefulness and limits of the ultrasonic examination in the diagnosis and prognosis of early pregnancies with vaginal bleeding]

Abstract

At the Department of Obstetrics and Gynecology of Catholic University in Rome 1257 pregnancies with vaginal bleeding in the first or second trimesters were ultrasonically observed. Pregnancy was found to be in normal development in 538 cases (42.80%); spontaneous abortion was reported in 688 cases (54.73%) and ectopic pregnancy, confirmed at surgery, in 31 cases (2.47%). The duration of bleeding appeared to have a significant effect on the prognosis of the pregnancy. Bleeding for 4 days or more predicted abortion almost significantly more often than a shorter bleeding episode. The spontaneous abortion rate increased with advancing maternal age and decreased with advancing gestational age. After detection of fetal life signs, the pregnancies ended in later abortion only in 9.29% of the cases. In this case there are no significant differences between normal or abnormal ultrasonic examinations. In our experience the ultrasound scanning, in patients with early pregnancy bleeding, is able to differentiate between live gestation or abortion but cannot predict the future.