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The Impact of Incidental Ultrasound Finding of Subchorionic and Retroplacental Hematoma in Early Pregnancy

  • Ayser Hashem
  • Samar Dawood SarsamEmail author
Original Article
  • 43 Downloads

Abstract

Background

Chorionic hematomas can be caused by the separation of the chorion from the endometrium, with an incidence of 3.1% of all pregnancies. It is the most common sonographic abnormality and the most common cause of first-trimester bleeding.

Objectives

To evaluate the impact of subchorionic and retroplacental hematomas detected by ultrasound in the first trimester of pregnancy.

Patients and Methods

A prospective observational case-control study was conducted at Elwiya Maternity Teaching Hospital on 100 pregnant ladies with subchorionic or retroplacental hematoma shown in ultrasound compared with 200 pregnant ladies without hematoma in the first trimester. The demographic feature, course of pregnancy, obstetric outcome, and neonatal outcome were analyzed.

Results

There was statistically significant difference between both groups regarding maternal and neonatal outcome. In regard to maternal outcome, there is increasing rate of miscarriage (20%, P = 0.004), preterm labor (18%, P = 0.005), intrauterine growth restriction (7%, P < 0.001), abruption (9%, P = 0.001), and cesarean section (60%, P < 0.001) compared to control group. Regarding neonatal outcome, there is increasing rate of low gestational age at birth (P = 0.004), low birth weight (P = 0.003), low Apgar score at 1 & 5 min (P < 0.001, P = 0.002, respectively), and more admission to NICU (P = 0.015) in study group when compared to control group.

Conclusion

  1. 1.

    The presence and the characteristic of an intrauterine hematoma during the first trimester may identify a population of patients at increased risk of adverse pregnancy outcome as miscarriage, preterm delivery, IUGR, abruption, low birth weight, cesarean section rate, low Apgar score at 1 and 5 min, and NICU admissions in patients with intrauterine hematoma.

     
  2. 2.

    The miscarriage rate with retroplacental hematoma is significantly higher than with subchorionic hematoma. The size of the hematoma is significantly greater in the miscarriage group.

     
  3. 3.

    All subchorionic hematomas disappeared, but 2% of retroplacental hematomas did not disappear until the end of second trimester.

     

Keywords

Retroplacental hematoma Subchorionic hematoma Miscarriage 

Notes

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

This study involves human participants. All procedures performed in this study involving human participants were in accordance with the ethical standards of the scientific committee at Al Kindy College of Medicine.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

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Copyright information

© Federation of Obstetric & Gynecological Societies of India 2018

Authors and Affiliations

  1. 1.Department of Obstetrics and GynecologyElwiya Maternity Teaching HospitalBaghdadIraq
  2. 2.Consultant Department of Obstetrics and GynecologyKindy College of MedicineBaghdadIraq

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