First trimester vaginal bleeding

OBJECTIVE: To estimate the cost of Rh testing and prophylaxis for first-trimester vaginal bleeding in the ambulatory setting. STUDY DESIGN: We used time-driven, activity-based costing to analyze tasks associated with Rh testing and prophylaxis of first-trimester vaginal bleeding at one hospital-based outpatient and two independent reproductive health clinics. At each site, we observed 10 patients undergoing Rh-typing and two patients undergoing Rh prophylaxis. We computed the costs of blood Rh-typing by both fingerstick and phlebotomy, cost of locating previous blood type in the electronic health record (available for 69...

BACKGROUND: The evaluation of patients with first-trimester vaginal bleeding and concern for early pregnancy loss (EPL) frequently occurs in the emergency department (ED), accounting for approximately 1.6% of all ED visits.1 Unfortunately, these patients consistently report negative experiences with ED care.2 - 8 In addition to environmental concerns, such as long wait times, patients often describe negative interactions with staff, including a perceived lack of empathy, the use of insensitive language, and inadequate counseling...

STUDY QUESTION: How does a natural proliferative phase (NPP) strategy for frozen embryo transfer (FET) compare with the conventional artificial (AC) and natural (NC) endometrial preparation protocols in terms of live birth rates (LBR)? SUMMARY ANSWER: This study supports the hypothesis that, just as for NC, NPP-FET may be a superior alternative to AC in terms of LBR. WHAT IS KNOWN ALREADY: Although FETs are increasing worldwide, the optimal FET protocol is still largely controversial...

INTRODUCTION: Interstitial pregnancies are a rare form of ectopic pregnancy with life threatening consequences. Thus, the aim of this report is to shed light on the importance of early diagnosis for optimal outcomes. CASE PRESENTATION: Herein, we present a case of an interstitial ectopic pregnancy in a 31-year-old Syrian female who presented only with mild non-specific abdominal pain. The ultrasound showed a gestational sac in the right horn of the uterus non-communicating with the endometrial cavity suggesting an interstitial ectopic pregnancy...

BACKGROUND: Pregnancy loss occurring before 20 weeks gestation is referred to as miscarriage. Various clinical presentations of miscarriage include threatened, inevitable, incomplete, complete, septic, and missed miscarriage. Early-stage threatened miscarriage may manifest with symptoms such as abdominal discomfort and vaginal bleeding. Threatened miscarriage is clinically defined as the manifestation of positive fetal heart sounds in pregnancies occurring before the 20th week of gestation, concomitant with vaginal bleeding and a closed cervix...

BACKGROUND: Abnormally sited placenta is considered a major life-threatening condition for pregnant woman, and many debate about the way of early diagnosis and management to decrease the mortality and morbidity. AIM OF STUDY: To evaluate the role of beta-human chorionic gonadotrophin (B-HCG) level in the first half of pregnancy as a marker for prediction of placenta previa. STUDY DESIGN: This is a prospective study done in Al-Yarmouk Teaching Hospital from first of January 2020 till first of January 2021...

BACKGROUND: Vaginal bleeding is the most common cause of presentation at the emergency department in the first trimester. Clinical presentation helps determine the likely cause of first-trimester vaginal bleeding. However, ultrasound imaging is required to reach a definitive diagnosis. OBJECTIVE: To determine the relationship between clinical diagnosis and ultrasonographic findings in women with first-trimester vaginal bleeding. METHODS: A prospective longitudinal study was conducted on 94 pregnant patients with a history of bleeding per vagina (PV) in the first trimester by using transvaginal ultrasound...

An ectopic pregnancy occurs when the fertilized egg is implanted and develops outside the endometrium, i.e. in the fallopian tubes, cervix, ovary, or abdomen. It commonly presents with a history of amenorrhoea, lower abdominal pain, and slight vaginal bleeding. The fallopian tube is the most typical location for ectopic pregnancy. Two percent of reported pregnancies are ectopic pregnancy. Ectopic pregnancy remains a public health threat for women in reproductive age, and a major cause of maternal mortalities in the first trimester...

Ectopic pregnancy, characterized by the aberrant implantation of blastocysts outside the uterine endometrial lining, typically occurs within the fallopian tube. Clinical presentation of tubal pregnancy ranges from asymptomatic cases to a spectrum of symptoms, including amenorrhea, pelvic pain, vaginal bleeding, and, critically, hemorrhagic shock resulting from tubal rupture. Utilizing serum beta-human chorionic gonadotropin levels and ultrasound examinations is pivotal in confirming the diagnosis. Diagnosing tubal pregnancy during the first trimester is feasible and crucial to prevent rupture, yet reports of fatal cases persist due to delays in diagnosis or misdiagnosis...

Background: Vaginal bleeding during pregnancy has been recognised as a significant risk factor for adverse pregnancy outcomes. This study aimed to investigate the association between vaginal bleeding during the first trimester of pregnancy and clinical adverse effects using a systematic review and meta-analysis. Methods: Databases of Scopus, Web of Science, PubMed (including Medline), Cochrane Library and Science Direct were searched until June of 2023. Data analysis using statistical test fixed- and random-effects models in the meta-analysis, Cochran and meta-regression...

Background Molar pregnancy (MP) incidence and clinical presentation vary significantly worldwide. Recent trends show changes in its clinical representation and incidence, particularly with the adoption of early diagnosis using first-trimester ultrasonography, which has reduced the prevalence of classical second-trimester presentations. This study aimed to analyze the changes in clinical presentation and incidence of MP among the Saudi population over the past 30 years. Methods In this retrospective study at King Fahad University Hospital, 121 complete mole (CM) pregnancy cases diagnosed and pathologically confirmed were reviewed...

BACKGROUND: Being obese can lead to various complications during pregnancy, such as Gestational Diabetes Mellitus (GDM), pregnancy induced hypertension (PIH), Pre-Eclampsia (PE), and Large Gestational Age (LGA). Although bariatric surgery is an effective way to treat obesity, it can also result in complications and may be linked to having small for gestational age (SGA) babies. This cohort study protocol aims to compare the maternal and fetal/neonatal outcomes of two groups of Iranian pregnant women: those who have undergone bariatric surgery and those who are obese but have not had bariatric surgery...

Recurrent pregnancy loss (RPL) affects approximately 5% of couples. Although RPL definitions vary across professional societies, an evaluation after a second clinically recognized first-trimester pregnancy loss is recommended. Good quality evidence links parental chromosomal rearrangements, uterine anomalies, and antiphospholipid syndrome (APS) to RPL. In contrast, the relationship between RPL and other endocrine, hematologic, and immunologic disorders or environmental exposures is less clear. Anticoagulant therapy and low-dose aspirin are recommended for patients with RPL who have also been diagnosed with APS...

Managing multiple pregnancies is challenging and requires careful evaluation. Point of care ultrasound (POCUS) has emerged as a potentially crucial tool in assessing suspected first-trimester pregnancies. However, its role in evaluating multiple pregnancies remains uncertain. We present the case of a 36-year-old Ghanaian female who presented with acute vaginal bleeding after undergoing in vitro fertilization. A bedside transabdominal POCUS identified four intrauterine gestations with fetal poles and cardiac activity, suggesting a quadruplet viable pregnancy...

INTRODUCTION: Early prediction of pregnancies destined to miscarry will allow couples to prepare for this common but often unexpected eventuality, and clinicians to allocate finite resources. We aimed to develop a prediction model combining clinical, demographic, and sonographic data as a clinical tool to aid counselling about first trimester pregnancy outcome. MATERIAL AND METHODS: This is a prospective, observational cohort study conducted at Queen Charlotte's and Chelsea Hospital, UK from March 2014 to May 2019...

Untreated vaginal bleeding during pregnancy can potentially give rise to various complications, with the incidence ranging from 12% to 40% of all cases. In Ayurveda, this condition is referred to as garbhashrava, which encompasses the manifestation of abortion, with raktadarshana (vaginal bleeding) serving as a key diagnostic symptom. In this present case study, 28 years old second gravida woman with amenorrhea of 3 months 08 days presented with vaginal bleeding (1 pad/day) for 15 days on and off. The case was diagnosed as first-trimester vaginal bleeding due to low-lying posterior placenta (placental cause)...

An ectopic pregnancy is located outside the uterus, mostly found in the fallopian tubes. The main predisposing factors are usually related to anatomical and/or functional disturbances of the fallopian tubes. Typically, an ectopic pregnancy presents with vaginal bleeding or abdominal pain in the first trimester of pregnancy, although it may be asymptomatic. The diagnosis of ectopic pregnancy, which is based on transvaginal ultrasound associated with the serum beta fraction of human chorionic gonadotropin values, is of the highest relevance due to the mortality risk involved...

OBJECTIVES: To evaluate the efficacy of combined mifepristone and misoprostol compared to misoprostol alone in outpatient medical treatment of first trimester miscarriage. Additionally, the study intends to compare the rate of complications, adverse effects, and treatment acceptability between groups. STUDY DESIGN: Single-center double-blind randomized placebo-controlled trial including women with diagnosis of missed first trimester miscarriage up to 9 weeks of gestation...

OBJECTIVE: To investigate whether letrozole pre-treatment is non-inferior to mifepristone pre-treatment, followed by misoprostol, for complete evacuation in the medical treatment of first-trimester missed miscarriage. DESIGN: Prospective open-label non-inferiority randomised controlled trial. SETTING: A university-affiliated hospital. POPULATION: We recruited 294 women diagnosed with first-trimester missed miscarriage who opted for medical treatment...

AIM: To evaluate the effect of progesterone use on fetal fraction (FF) in non-invasive prenatal testing (NIPT) due to the threat of first trimester miscarriage. METHODS: This case control study included the pregnant who were referred to our clinic for non-invasive prenatal testing. The patients were categorized into three groups: Pregnant women with vaginal bleeding and using progesterone, pregnant women with vaginal bleeding and not using progesterone, and pregnant women without bleeding...