Ultrasonographic evaluation of pelvic pain in first trimester of pregnancy: a prospective study

Authors

  • Riya Samanta Department of Radiodiagnosis, Lady Hardinge Medical College and Associated Hospitals, New Delhi, Delhi, India
  • Rama Anand Department of Radiodiagnosis, Lady Hardinge Medical College and Associated Hospitals, New Delhi, Delhi, India
  • Ravi S. Solanki Department of Radiodiagnosis, Lady Hardinge Medical College and Associated Hospitals, New Delhi, Delhi, India
  • Reena Yadav Department of Obstetrics and Gynecology, Lady Hardinge Medical College and Associated Hospitals, New Delhi, Delhi, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20232283

Keywords:

Ectopic pregnancy, Pelvic pain, Spontaneous abortion, Ultrasonagraphy, First trimester of pregnancy

Abstract

Background: Early and accurate diagnosis of the cause of pelvic pain in first trimester of pregnancy is essential for appropriate clinical decision making thereby enabling correct and timely management. The aim of the study was to evaluate the role of ultrasonography in evaluation various causes of pelvic pain in the first trimester of pregnancy and correlate the imaging findings with clinical/per-operative findings.

Methods: This was a prospective observational study approved by the Institutional Review Board and conducted from November 2016 to March 2018. 67 patients with pelvic pain in their first trimester, attending the antenatal clinic or OBG emergency underwent pelvic ultrasonography and the findings were correlated with clinical/per-operative findings.

Results: Ectopic pregnancies formed the largest individual group comprising of 45 (67.2%) cases of the total study population followed by spontaneous abortion 5(7.5%). Other causes included subchorionic haemorrhage, ovarian torsion, uterine fibroid, simple/haemorrhagic/dermoid cyst of ovary and acute appendicitis. 4 (6%) patients had normal intrauterine pregnancy.

Conclusions: Ultrasonography has high diagnostic accuracy of 94% and 100% sensitivity for detecting the cause of first trimester pelvic pain.

References

Kim ET, Singh K, Moran A, Armbruster D, Kozuki N. Obstetric ultrasound use in low and middle income countries: a narrative review. Reproduct Heal. 2018;15(1):129.

Amirbekian S, Hooley RJ. Ultrasound evaluation of pelvic pain. Radiologic Clinics. 2014;52(6):1215-35.

Bhosale PR, Javitt MC, Atri M, Harris RD, Kang SK, Meyer BJ, et al. ACR appropriateness criteria® acute pelvic pain in the reproductive age group. Ultras Quarter. 2016;32(2):108-15.

Beals T, Naraghi L, Grossestreuer A, Schafer J, Balk D, Hoffmann B. Point of care ultrasound is associated with decreased ED length of stay for symptomatic early pregnancy. Ame J Emerg Med. 2019;37(6):1165-8.

Martin E, Shaw A, Lees C. Survey of current practice in clinical transvaginal ultrasound scanning in the UK. Ultrasound. 2015;23(3):138-48.

Burns M, Hague CJ, Vos P, Tiwari P, Wiseman SM. Utility of magnetic resonance imaging for the diagnosis of appendicitis during pregnancy: A Canadian experience. Canad Assoc Radiol J. 2017;68(4):392-400.

Theilen LH, Mellnick VM, Longman RE, Tuuli MG, Odibo AO, Macones GA, et al. Utility of magnetic resonance imaging for suspected appendicitis in pregnant women. Ame J Obstet Gynaecol. 2015;212(3):345-e1.

Lee R, Dupuis C, Chen B, Smith A, Kim YH. Diagnosing ectopic pregnancy in the emergency setting. Ultrasonogra. 2018;37(1):78.

Zheng D, Li C, Wu T, Tang K. Factors associated with spontaneous abortion: a cross-sectional study of Chinese populations. Reproduct Heal. 2017;14(1):33.

Jacob L, Kalder M, Kostev K. Risk factors for ectopic pregnancy in Germany: a retrospective study of 100,197 patients. GMS German Med Sci. 2017;15.

Li C, Zhao WH, Meng CX, Ping H, Qin GJ, Cao SJ, et al. Contraceptive use and the risk of ectopic pregnancy: a multi-center case-control study. Plos one. 2014;9(12):e115031.

Bahouth SM, Wong VK, Kampalath RV, Lin J, Mankowski-Gettle L. US findings of first-trimester pregnancy RadioGraphics fundamentals| online presentation. RadioGraphics. 2018;38(7):2193-4.

Alalade AO, Smith FJ, Kendall CE, Odejinmi F. Evidence-based management of non-tubal ectopic pregnancies. J Obstet Gynaecol. 2017 Nov 17;37(8):982-91.

Geetanjali K, Raghavan S, Selvi DG. Medical termination of pregnancy in bicornuate uterus with twin gestation. Trop J Obstet Gynaecol. 2019;36(3):474.

Park SB, Han BH, Lee YH. Ultrasonographic evaluation of acute pelvic pain in pregnant and postpartum period. Med Ultrasono. 2017;19(2):218-23.

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Published

2023-07-28

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Original Research Articles