Publication:

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

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.