Do First-Trimester Subchorionic Hematomas Affect Pregnancy Outcomes?

Abstract

Objective The aim of this study is to investigate the relationship between first trimester subchorionic hematomas and pregnancy outcomes in women with singleton pregnancies.

Material and methods Between January 2018 and January 2019, patients who had a single pregnancy between the 6th and 14th weeks of their pregnancy and were hospitalized with the diagnosis of abortus imminens in the early pregnancy service were included in the study. According to the ultrasonographic examination, those with subchorionic hematoma and those with no hematoma were compared in terms of demographic data, pregnancy outcomes and pregnancy complications.

Results 400 abortus immines cases with subchorionic hematoma and 400 abortus imminens cases without subchorionic hematoma were compared. Preterm delivery percentages were similar in both groups, however abortus percentage was significantly higher in the hematoma group (34.2 vs. 24.7%; p=0.007). In addition, it was revealed that the presence of subchorionic hematoma before the 20th gestational week increased the risk of miscarriage 1.58 times. However, no data could be found in the study that could correlate the size of the hematoma with pregnancy loss.

Conclusion The presence of subchorionic hematoma increases abortion rates in abortus imminens cases. And the presence of subchorionic hematoma in cases with ongoing pregnancy does not increase the complications of delivery.

Key words

abortion - subchorionic hematoma - ultrasonography - threatened miscarriage - pregnancy outcomes

Publikationsverlauf

Eingereicht: 02. Juli 2022

Angenommen nach Revision: 12. August 2022

Artikel online veröffentlicht:
28. September 2022

• References

• 1 Seki H, Kuromaki K, Takeda S. et al. Persistent subchorionic hematoma with clinical symptoms until delivery. Int J Gynaecol Obstet 1998; 63: 123-128
• 2 Johns J, Hyett J, Jauniaux E. Obstetric outcome after threatened miscarriage with and without a hematoma on ultrasound. Obstet Gynecol 2003; 102: 483-487
• 3 Xiang L, Wei Z, Cao Y. Symptoms of an intrauterine hematoma associated with pregnancy complications: a systematic review. PloS One 2014; 9: e111676
• 4 Tuuli MG, Norman SM, Odibo AO. et al. Perinatal outcomes in women with subchorionic hematoma: a systematic review and meta-analysis. Obstet Gynecol 2011; 117: 1205-1212
• 5 Akhlaghpoor S, Tomasian A. Safety of chorionic villus sampling in the presence of asymptomatic subchorionic hematoma. Fetal Diagn Ther 2007; 22: 394-400
• 6 Zhou J, Wu M, Wang B. et al. The effect of first trimester subchorionic hematoma on pregnancy outcomes in patients underwent IVF/ICSI treatment. J Matern Fetal Neonatal Med 2017; 30: 406-410
• 7 Sotiriadis A, Papatheodorou S, Makrydimas G. Threatened miscarriage: evaluation and management. BMJ 2004; 329: 152-155
• 8 Committee Opinion No 700: Methods for Estimating the Due Date. Obstet Gynecol 2017; 129: e150-e154
• 9 Seçkin KD, Çetinkaya S, Karslı MF. et al. Preterm Eylem Tehdidi Olgularında Akut Faz Reaktanlarının Preterm Doğumu Öngörmedeki Yeri. Jinekoloji-Obstetrik ve Neonatoloji Tıp Dergisi 2015; 12: 6-9
• 10 Børlum KG, Thomsen A, Clausen I. et al. Long-term prognosis of pregnancies in women with intrauterine hematomas. Obstet Gynecol 1989; 74: 231-233
• 11 Nagy S, Bush M, Stone J. et al. Clinical significance of subchorionic and retroplacental hematomas detected in the first trimester of pregnancy. Obstet Gynecol 2003; 102: 94-100
• 12 Ball RH, Ade CM, Schoenborn JA. et al. The clinical significance of ultrasonographically detected subchorionic hemorrhages. Am J Obstet Gynecol 1996; 174: 996-1002
• 13 Naert MN, Khadraoui H, Muniz Rodriguez A. et al. Association between first-trimester subchorionic hematomas and pregnancy loss in singleton pregnancies. Obstet Gynecol 2019; 134: 276-281
• 14 Magnus MC, Wilcox AJ, Morken NH. et al. Role of maternal age and pregnancy history in risk of miscarriage: prospective register based study. BMJ 2019; 364: l869
• 15 Coomarasamy A, Devall AJ, Brosens JJ. et al. Micronized vaginal progesterone to prevent miscarriage: a critical evaluation of randomized evidence. Am J Obstet Gynecol 2020; 223: 167-176
• 16 Ben-Haroush A, Yogev Y, Mashiach R. et al. Pregnancy outcome of threatened abortion with subchorionic hematoma: possible benefit of bed-rest?. Isr Med Assoc J 2003; 5: 422-424
• 17 Johns J, Jauniaux E. Threatened miscarriage as a predictor of obstetric outcome. Obstet Gynecol 2006; 107: 845-850
• 18 Strobino B, Pantel-Silverman J. Gestational vaginal bleeding and pregnancy outcome. Am J Epidemiol 1989; 129: 806-815
• 19 Wijesiriwardana A, Bhattacharya S, Shetty A. et al. Obstetric outcome in women with threatened miscarriage in the first trimester. Obstet Gynecol 2006; 107: 557-562