Subchorionic hematoma as a risk factor of pregnancy and delivery in women with threatening abortion

Abstract

Summary Objectives: The aim was to present pregnancy complications and outcome in the group of women with subchorionic hematoma (SCH) diagnosed in the first or second trimester of pregnancy. Methods: A retrospective study was performed to compare the perinatal outcome of 41 patients with SCH (study group) with 59 women treated of threatening abortion (control group). Age, obstetric history, the course of pregnancy and obstetric outcomes were analyzed. Results: More SCH patients lost the pregnancy before 22 weeks gestation when Compared to the control group (39.02% vs. 15.3%). The mean age of women in both groups was similar, but a previous loss of pregnancy was more often observed in SCH group (24.4% vs. 9.4%). The majority of SCH women were multiparas (63.25% vs. 43,75%). The frequency of perinatal complications such as premature delivery, intrauterine growth retardation (IUGR) or premature rupture of membranes (PROM), was similar in both groups, but pregnancy-induced hypertension (PIH) was observed more often in SCH group (p=0,008). The percentage of caesarean sections, the average condition of the newborns in Apgar score and weight were similar in both groups. There were no differences either in the frequency of meconium stained fluid or the presence of late decelerations in delivery CTG pattern. The patients with SCH delivered female fetuses more frequently; 81.25 % of those who delivered vaginally had incomplete placenta. Conclusions: 1. SCH is more frequent in multiparas, especially if previous pregnancy loss was reported. 2. About 40% of pregnancies with SCH are lost before 22 weeks gestation; bleeding is a bad prognostic factor. 3. SCH diagnosed at the beginning of pregnancy is a risk factor of PIH in the third trimester. 4. SCH diagnosed in early pregnancy does not influence the method of delivery and does not increase the risk of adverse pregnancy outcome.