Do First-Trimester Subchorionic Hematomas Affect Pregnancy
                    Outcomes?

Elmas, Burak; Özgü, Burçin Salman; ZORLU, Uğurcan; Koç, Bergen Laleli; Ozdemir, Eda Ureyen; Akkaya, Selver Kübra; AKAY, Arife; Öztürk, Neslihan; Erkaya, Salim

doi:10.1055/a-1929-9500

Cited by 3 publications

(2 citation statements)

References 20 publications

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“…A study indicated that the size of the hematoma estimated as a fraction of gestational sac size significantly correlated with first-trimester pregnancy loss [12]. In our study, similar to the conclusion of studies in 2019 [10] and in 2022 [27], the estimated size of SCH was not associated with miscarriage. The presence or absence of a hematoma may be one of the indicators that the placenta was functioning properly, independent of its number and size.…”

Section: Discussionsupporting

confidence: 89%

The impact of first-trimester subchorionic hematomas on pregnancy outcomes after euploid embryo transfer: a retrospective cohort study

Wang,

Zhao,

Liu

et al. 2024

BMC Pregnancy Childbirth

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Background The aim of the retrospective cohort study was to investigate the prognostic effect of subchorionic hematomas (SCH) in the first trimester on pregnancy outcomes after euploid embryo transfer. Methods We retrospectively analyzed women achieving singleton pregnancy by PGT-A or PGT-SR from January 2017 to January 2022. Patients were enrolled in the study if they had a viable intrauterine pregnancy at ultrasound between 6 0/7 and 8 0/7 weeks of gestation. Pregnancy outcomes as well as the incidence of maternal complications were compared between patients with and without SCH. Logistic regression was used for adjusting for potential confounding factors. Results A total of 1539 women were included, of which 298 with SCH and 1241 with non-SCH. The early miscarriage rate in SCH group was significantly higher than that in the non-SCH group (10.1% vs. 5.6%, adjusted odds ratio [aOR] 1.99, 95% confidence interval [CI] 1.25–3.16, P = 0.003). The live birth rate in SCH group was significantly lower than that in the non-SCH group. (85.6% vs. 91.2%, aOR 0.57, 95% CI 0.39–0.84, P = 0.005). In addition, SCH group had an increased risk of hypertensive disorder of pregnancy (HDP) (8.9% vs. 5.2%, P = 0.022), especially in hematoma with bleeding (19.3% vs. 6.0%, P = 0.002). The incidence of gestational diabetes mellitus (GDM), major congenital abnormalities rate, normal birth weight rate and low birth weight rate were similar between the two groups. Conclusions The presence of SCH in the first trimester was associated with worse pregnancy outcomes after euploid embryo transfer, including an increased risk of early miscarriage and hypertensive disorder of pregnancy, along with a reduced live birth rate.

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Section: Discussionsupporting

confidence: 89%

The impact of first-trimester subchorionic hematomas on pregnancy outcomes after euploid embryo transfer: a retrospective cohort study

Wang,

Zhao,

Liu

et al. 2024

BMC Pregnancy Childbirth

View full text Add to dashboard Cite

show abstract

“…On the other hand, some studies have reported that the presence of SCH increases the risk of adverse pregnancy outcomes such as abortion, premature delivery and premature rupture of membranes, for example, Li Y and Alijotas J et al found that compared with normal pregnant women, the positive rate of autoantibodies such as anti-nuclear antibodies and anti-cardiolipin in SCH patients increased. [4,5] Several studies have reported the effect of SCH on pregnancy outcomes, such as SCH was associated with an increased risk of spontaneous abortion, preterm birth and premature rupture of membranes (PROM). [6,7] The exact etiology of SCH is still unclear.…”

Section: Introductionmentioning

confidence: 99%

Analysis of risk factors and pregnancy outcomes in pregnant women with subchorionic hematoma

Xu,

Lun,

Wang

et al. 2023

Medicine

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Subchorionic hemorrhage (SCH) or hematoma is one of the abnormal ultrasonic manifestations. At present, there are few studies on the pathogenesis of SCH, and its underlying mechanism is still unclear. It may be related to abnormal placenta formation and implantation, autoimmune dysfunction, and coagulation dysfunction. As a unique complication of pregnancy, SCH has a controversial effect on pregnancy outcome. The aim of the present study was to explore the possible etiology of SCH, especially its association with autoimmune dysfunctions, as well as the pregnancy outcomes of SCH patients. This retrospective cohort study was conducted at the Third Affiliated Hospital of Zhengzhou University. Patients with a singleton pregnancy of ≤14 weeks gestation from June 2021 to June 2022 were included. Patients with SCH detected by ultrasound were selected as the study group, while patients without SCH during the same period were chosen as the control group. Immunological indicators and pregnancy outcomes were primarily compared between the 2 groups. The decrease in protein S activity and antithrombin-III levels, the increase in homocysteine levels, and the presence of autoantibodies (such as lupus anticoagulant, anticardiolipin antibody, and antinuclear antibody spectrum) were found to be risk factors for SCH. SCH in the first trimester was associated with higher rates of premature rupture of membranes (13.5% vs 3.8%) and miscarriage (14.4% vs 6.4%). However, there were no significant differences in the rates of placental abruption, fetal distress, cesarean section, neonatal birth weight, and gestational age. The incidence of miscarriage was also significantly higher in patients with subchorionic hematoma (SCH) who tested positive for autoantibodies (28.2% vs 7.6%). There were no significant differences in other clinical characteristics and pregnancy outcomes between patients with SCH who had positive autoantibodies and those who did not. The occurrence of SCH may be related to maternal immune abnormalities. SCH may increase the risk of premature rupture of membranes and abortion. However, there is no correlation between the presence or absence of SCH and neonatal outcomes.

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Effect of subchorionic hematoma on first-trimester maternal serum free β-hCG and PAPP-A levels

Akay,

Reis,

Şahin

et al. 2024

Revista Brasileira De Ginecologia E Obstetrícia

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Objective: This study aimed to investigate the effects of the presence of subchorionic hematoma (SH) in early pregnancies with threatened miscarriage (TM) on levels of first-trimester maternal serum markers, pregnancy-associated plasma protein-A (PAPP-A), and free β-human chorionic gonadotropin (β-hCG) levels. Methods:The data of TM cases with SH in the first trimester between 2015 and 2021 were evaluated retrospectively. The data of age and gestational age-matched TM cases without SH were also assessed to constitute a control group. Demographic characteristics, obstetric histories, ultrasonographic findings, and free β-hCG and PAPP-A levels of the groups were compared.Results: There were 119 cases in the study group and 153 cases in the control group. The median vertical and longitudinal lengths of the SH were 31 mm and 16 mm. The median age of both groups was similar (p=0.422). The MoM value of PAPP-A was 0.088 (.93) in the study group and 0.9 (0.63) in the control group (p=0.519). Similarly, the MoM value of free β-hCG was 1.04 (0.78) in the study group and 0.99 (0.86) in the control group (p=0.66). No significant relationship was found in the multivariate analysis between free β-hCG MoM, PAPP-A MoM, age, gravida, and vertical and longitudinal lengths of the hematoma (p>0.05). Conclusion:The level of PAPP-A and free β-hCG were not affected by the SH. Therefore, these markers can be used reliably in TM cases with SH for the first-trimester fetal aneuploidy screening test.

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Do First-Trimester Subchorionic Hematomas Affect Pregnancy Outcomes?

Cited by 3 publications

References 20 publications

The impact of first-trimester subchorionic hematomas on pregnancy outcomes after euploid embryo transfer: a retrospective cohort study

The impact of first-trimester subchorionic hematomas on pregnancy outcomes after euploid embryo transfer: a retrospective cohort study

Analysis of risk factors and pregnancy outcomes in pregnant women with subchorionic hematoma

Effect of subchorionic hematoma on first-trimester maternal serum free β-hCG and PAPP-A levels

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