title: Ultrasound assessment of premenopausal bleeding.
abstract: Vaginal bleeding is the most common cause of emergency care in the first trimester of pregnancy and accounts for the majority of premenopausal bleeding cases. Ultrasound evaluation combined with a quantitative beta human chorionic gonadotropin test is an established diagnostic tool to assess these patients. Spontaneous abortion because of genetic abnormalities is the most common cause of vaginal bleeding; ectopic pregnancy and gestational trophoblastic disease are other important causes and in all patients presenting with first trimester bleeding, ectopic pregnancy should be suspected and excluded, as it is associated with significant maternal morbidity and mortality. A thorough knowledge of the normal sonographic appearance of intrauterine gestation is essential to understand the manifestations of an abnormal gestation. Arteriovenous malformation of the uterus is a rare but important cause of vaginal bleeding in the first trimester, as it has to be differentiated from the more common retained products of conception, with which it is often mistaken.
authors.affiliation: Department of Radiology, University Hospitals, Case Medical Center, Case Western Reserve University, Cleveland, OH 44106, USA.
authors.forename: Raj M
authors.initials: RM
authors.lastname: Paspulati
authors.forename: Ahmet T
authors.initials: AT
authors.lastname: Turgut
authors.forename: Shweta
authors.initials: S
authors.lastname: Bhatt
authors.forename: Elif
authors.initials: E
authors.lastname: Ergun
authors.forename: Vikram S
authors.initials: VS
authors.lastname: Dogra
mesh_terms: D000022:Abortion, Spontaneous / Q000000981:diagnostic imaging; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood; D005321:Extraembryonic Membranes / Q000000981:diagnostic imaging; D005260:Female; D005865:Gestational Age; D058746:Gestational Sac / Q000000981:diagnostic imaging; D006801:Humans; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011271:Pregnancy, Ectopic / Q000000981:diagnostic imaging; D017697:Premenopause; D016216:Ultrasonography, Prenatal; D014592:Uterine Hemorrhage / Q000000981:diagnostic imaging*; D015017:Yolk Sac / Q000000981:diagnostic imaging
chemical_list: D018997:Chorionic Gonadotropin, beta Subunit, Human