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Year : 2022  |  Volume : 10  |  Issue : 2  |  Page : 71-75

Association between clinical and ultrasound diagnoses of aetiologies of vaginal bleeding in the first trimester

1 Department of Public Health and Hygiene, Faculty of Health Sciences, University of Buea, Buea, Cameroon
2 Clinton Health Access Initiative, Yaounde; Institute for Global Health, Siena University, Siena, Italy
3 Department of Obstetrics and Gynaecology, University Hospitals of North Midlands, United Kingdom; Health Education and Research Organizations (HERO), Douala
4 Department of Medicine, Faculty of Health Sciences, University of Buea, Buea; Department of Obstetrics and Gynaecology, Douala General Hospital, Douala, Cameroon

Correspondence Address:
Dr. Nkengfua Samuel
Department of Public Health and Hygiene, Faculty of Health Sciences, University of Buea, Buea
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jihs.jihs_7_22

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Introduction: The prevalence of first-trimester vaginal bleeding (FTVB) ranges worldwide from 4% to 24%. In resource-limited settings, there is a heavy reliance on clinical presentation to establish the cause of bleeding due to the limited availability of ultrasounds (US) imaging modalities. Objectives: The objective is to determine the association between clinical and US diagnoses in FTVB at the Buea and Limbe regional hospitals (BRH and LRH). Subjects and Methods: We recruited 144 participants, with <14 weeks of gestational age at the BRH and LRH. Data on sociodemographic, clinical, and US diagnoses were obtained from patients. Statistical significance was considered at P < 0.05. Results: From 144 participants enrolled, 55 (38.2%) were from BRH and 89 (61.8%) were from LRH. The main causes of FTVB were threatened abortions (42.36%), incomplete abortion (27.8%), complete abortion (3.5%), missed abortion (1.4%), ectopic pregnancy (22.91%), molar pregnancy (0.91%), and pregnancy with fibroids (1.4%). Cohen's kappa analysis revealed a good degree of agreement between clinical and US diagnoses for elective consultations (κ = 0.634, P < 0.001) and an average degree of agreement for those consulting as referrals (κ = 0.520, P < 0.001). Our study revealed a significant statistical association between clinical and US diagnoses for the following pathologies: threatened abortion (P < 0.001), incomplete abortion (P = 0.004), complete abortion (P < 0.019), and ectopic pregnancy (P < 0.001). Conclusion: This study reveals an overall average consistency between clinical and US diagnoses, especially for common etiologies of bleeding in early pregnancy. Hence, the need for US to confirm clinical diagnoses.

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