Pregnancy outcome in women with subchorionic haemorrhage detected in first and second trimester of pregnancy

  • Parez Retha ----- Department of Gynecology and Obstetrics, College of medicine, Hawler Medical University, Erbil, Iraq.
  • Samira S. Shekh Mohammed Department of Gynecology and Obstetrics, Erbil Maternity Hospital, Erbil, Iraq.
  • Parween Omer Hassen Department of Ultrasonogaphy, Erbil Maternity Hospital, Erbil, Iraq.
Keywords: Subchorionic hemorrhage, Ultrasonography, Pregnancy outcome

Abstract

Background and objective: Subchorionic hemorrhage is the most common sonographic abnormalities and the most common cause of first trimester miscarriage and mainly associated with vaginal bleeding. The present study was conducted with an aim to find out the effect of subchorionic hemorrhage in first and second trimester of pregnancy outcome.

Methods: A case cohort prospective study was designed to investigate 100 patients having a subchorionic hematoma in the presence of singleton live embryo or fetus. The study assessed the association of the volume size of subchorionic hematoma, maternal age and gestational age at time of the diagnosis with adverse pregnancy outcomes.

Results: The incidence of miscarriage and preterm delivery was 35% and 21% respectively. The mean (±SD) age of those who aborted was 29.97 ± 7.0 years, slightly higher than the mean age of those who ended with preterm delivery (27.7 ± 5.87 years) and those continued with their pregnancies to viability (28.3 ± 6.2 years). There was a statistically significant association between previous histories of preterm delivery and pregnancy outcome (P =0.015). Miscarriage was significantly high among women with gestational age <12 weeks, while term pregnancy was significantly high among women with gestational age >13 weeks (P <0.001). The estimated volume of the hematoma did not correlate with the outcome of the pregnancy, perhaps it is the presence or absence of a hematoma as a marker of the integrity of placentation and not its size.

Conclusion: Subchorionic hematoma in first and second trimester of pregnancy associated with adverse pregnancy outcome (spontaneous miscarriage and preterm delivery.  

References

Abu-Yousef MM, Bleider JJ, Williamson RA, Weiner CP. Subchorionic hemorrhage: Sonographic diagnosis and clinical significance. Am J Roentgenol 1987;149:737-40.

Bennett GL, Bromley B, Lieberman E, Benacerraf BR. Subchorionichemorrhage in first-trimester pregnancies: prediction of pregnancyoutcome with sonography. Radiology 1996; 200:803-6.

Kyser KL. Meta-analysis of subchorionic haemorrhage and adverse pregnancy outcome. ProcObstetGynecol2012; 2(4).

Mantoni M. Ultrasound signs in threatened abortion and their prognostic significance. ObstetGynecol 1985; 65:471-5.

Kurjak A, Schulman H, Zudenigo D, Kupesic S, Kos M, Goldenberg M. Subchorionic hematomas in early pregnancy: clinical outcome and blood flow patterns. Maternal Fetal Medicine 1996; 5: 41-4.

Baxi LV, Pearlstone MM. Subchorionic hematomas and the presence of autoantibodies. Am JObstetGynecol 1991; 165:1423-4.

Loi K, Tan K T. Massive pre-placental and subchorionichaematoma. Singapore Med J 2006; 47(12):1085.

LieteJ, Ross P, Rossi AC, Philippe J. Prognosis of very large first trimester heamatoma. Ultrasound Med 2006; 25:1441-5.

Pedersen JG, Mantoni M. Large intrauterine hematoma in threatened miscarriage. Frequency and clinical consequences. Br J Obstetric Gynaecol1990; 97:75-7.

Nagy S, Bush M, Stone J, Lipinski RH, Gardo S. Clinical significance of sub chorionic and retro placental hematomas detected in the first trimester of pregnancy. Obstetric Gynecol 2003; 102(1):94-100.

Johns J, Hyett J, Jauniaux E. Obstetric outcome after threatened miscarriage with and without a hematoma on ultrasound. Obstetric Gynecol 2003; 102(3):483-7.

Saurbrei EE, Pham DH. Placental abruption and sub chorionic hemorrhage in the first half of pregnancy: US appearance and clinical outcome. Radiology 1986; 160:109-12.

Published
2018-09-26
How to Cite
-----, P., Shekh Mohammed, S., & Hassen, P. (2018). Pregnancy outcome in women with subchorionic haemorrhage detected in first and second trimester of pregnancy. Zanco Journal of Medical Sciences (Zanco J Med Sci), 19(2), 1035 - 1040. https://doi.org/10.15218/zjms.2015.0028
Section
Original Articles