Outcomes of subchorionic hematoma‐affected pregnancies in the infertile population

Inman, Erin; Miranian, Daniel; Stevenson, Micaela J.; Kobernik, Emily K.; Moravek, Molly B.; Schon, Samantha B.

doi:10.1002/ijgo.14162

Cited by 10 publications

(6 citation statements)

References 29 publications

(70 reference statements)

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“…In Table I, baseline demographic characteristics were compared and listed, such as maternal age, BMI, parity and previous history of dilation and curettage (D&C), IVF, gestational age of the onset of symptoms and delivery. The median maternal ages were 32 (20-45) and 31 years old in the TA and control group respectively, while the median BMIs were 21 (16-32) and 21 (16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31) kg/m 2 . No significant differences were found in the distribution of age (p = 0.12) and BMI between these groups (p = 0.82).…”

Section: Resultsmentioning

confidence: 95%

“…However, several studies had failed to find an association between SCH and adverse pregnancy and perinatal outcomes. Inman et al [30] analyzed 1210 patients with an incidence of 12.5% of SCH and it was found that SCH did not increase the risk of pre-eclampsia, placenta accreta spectrum, and placental abruption or any other adverse pregnancy and perinatal outcomes. Interestingly, we found a trend toward a decreased incidence of placenta previa among women who had SCH during early pregnancy.…”

Section: Discussionmentioning

confidence: 99%

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Placenta retention is associated with threatened abortion at the early stage of pregnancy

He¹,

Liu²

2023

jogi

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Introduction: Retained placenta (RP) is an obstetric issue complicating around 3% of normal deliveries. Previous studies identified various risk factors for RP. In clinical experience, women with a history of threatened abortion (TA) often are noted to have a higher risk of RP. Yet, limited research has been performed in this area. Aim: To explore the association between RP and TA. Material and methods: A retrospective cohort study including 219 women with viable pregnancies who had TA and 219 women who had not experienced TA with no evidence of subchorionic hematoma (SCH) between January 2019 and January 2021 were included. Demographic information and adverse pregnancy outcomes were compared.Women who had TA were further divided into two groups: SCH group and non-SCH group, and their demographic information and adverse pregnancy outcomes were also compared. c 2 tests or Mann-Whitney U-tests were used for categorical/continuous variables respectively. Results: The incidence of RP among women with TA was 25/219, compared to 10/219 in the control group (aOR = 2.33, 95% CI: 1.05-5.13, p = 0.04). Women had TA were at a higher risk of postpartum hemorrhage (aOR = 3.73, 95% CI: 1.68-8.27, p = 0.001). In addition, women with SCH were less likely to develop placenta previa (p = 0.04). However, when adjusted for confounders, the difference was not significant (aOR = 0.16, 95% CI: 0.02-1.26, p = 0.08). Conclusions: We found that threatened abortion is associated with a higher risk of retained placenta as well as postpartum hemorrhage. Therefore, active management at the third stage of labor was recommended among women with a history of threatened abortion.

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Section: Resultsmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Placenta retention is associated with threatened abortion at the early stage of pregnancy

He¹,

Liu²

2023

jogi

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“…In contrast, a study in 2017 found that the birth weight of SCH singleton pregnancies in IVF/ICSI was lower than that of SCH-free singleton pregnancies, but also not associated with pregnancy loss [ 8 ]. For infertile individuals, previous study reported no increased risk of miscarriage [ 22 ]. However, when patients noticed both vaginal bleeding and cramping, the likelihood of miscarriage increased significantly.…”

Section: Discussionmentioning

confidence: 99%

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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“…One of the most important reasons for this discrepancy was the different study populations involved. Some researches focused on infertile women with embryo transfers or other assisted reproductive techniques who may be accompanied by the vaginal bleeding [ 14 , 15 ], while our study focused on the asymptomatic subchorionic hematoma women without assisted reproduction.…”

Section: Discussionmentioning

confidence: 99%

“…However, the association of subchorionic hematoma with adverse pregnancy outcomes remains inconclusive based on the limited data [ 6 , 9 , 10 ], with some studies demonstrating increased rates of complications like pregnancy loss, placental abruption, preterm birth, premature rupture of membranes, cesarean delivery, preeclampsia and fetal growth restriction [ 4 , 9 , 11 – 13 ], while others failing to demonstrate any link [ 5 , 10 , 14 , 15 ]. For example, a retrospective cohort study demonstrated that women with ultrasound-detected subchorionic hemorrhage before 22 weeks of gestation had an increased risk of placental abruption and preterm birth [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

Associations between the size and duration of asymptomatic subchorionic hematoma and pregnancy outcomes in women with singleton pregnancies

Pan

Lan

Zhou

et al. 2023

BMC Pregnancy Childbirth

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Background The purpose of this study was to investigate the relationship between the size and duration of asymptomatic subchorionic hematoma and pregnancy outcomes in women with singleton pregnancies. Methods This was a retrospective study that enrolled 701 singleton pregnant women who were diagnosed with asymptomatic subchorionic hematoma by ultrasound at 5–10 gestational weeks. The control group recruited 640 normal pregnant women without subchorionic hematoma who were matched with subchorionic hematoma group on baseline characteristics. The pregnancy outcomes were compared between the two groups, and the associations of the size and duration of subchorionic hematoma with pregnancy outcomes were analyzed by logistic regression model. Results Compared with the normal pregnancy group, the incidence of, gestational diabetes mellitus, gestational thrombocytopenia, placenta adhesion, fetal growth restriction, macrosomia in subchorionic hematoma group were higher (all P < 0.05). After adjusting for confounding factors, the hematoma size was positively associated with the occurrence of gestational hypothyroidism (adjusted OR[95%CI]: 1.029[1.004–1.054]), intrahepatic cholestasis of pregnancy (adjusted OR[95%CI]: 1.095[1.047–1.146]), term premature rupture of membranes (adjusted OR[95%CI]: 1.044[1.005–1.085]), hypertensive disorders of pregnancy (adjusted OR[95%CI]: 1.030[1.0004-1.060]), gestational thrombocytopenia (adjusted OR[95%CI]: 1.078 [1.045–1.113]), placenta adhesion (adjusted OR[95%CI]: 1.054 [1.027–1.082]), and the duration of hematoma was positively associated with the incidence of term premature rupture of membranes (adjusted OR[95%CI]: 1.070[1.027–1.115]), gestational diabetes mellitus (adjusted OR[95%CI]: 1.938 [1.886–1.993]) and fetal growth restriction (adjusted OR[95%CI]: 1.194 [1.124–1.268]). Conclusions The presence, size and duration of a first-trimester asymptomatic subchorionic hematoma may be associated with adverse pregnancy outcomes at later gestations such as term premature rupture of membranes and fetal growth restriction.

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Outcomes of subchorionic hematoma‐affected pregnancies in the infertile population

Cited by 10 publications

References 29 publications

Placenta retention is associated with threatened abortion at the early stage of pregnancy

Placenta retention is associated with threatened abortion at the early stage of pregnancy

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

Associations between the size and duration of asymptomatic subchorionic hematoma and pregnancy outcomes in women with singleton pregnancies

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