Prenatal ultrasound diagnosis of massive subchorionic thrombohematoma

Massive subchorionic hematoma is a localized collection of blood or hematoma in the placenta, and can result in serious obstetrical complications. The condition can be diagnosed antenatally by ultrasound. However, no reports have previously described the same condition featuring an intraplacental fluid–fluid level on imaging studies. We report a case of massive subchorionic hematoma diagnosed prenatally, and propose an additional peculiar finding detectable on both the ultrasound and magnetic resonance images: the intraplacental fluid–fluid level. We also review previously reported cases that were detected by ultrasonography.

Section: Discussionmentioning

confidence: 46%

Massive Subchorionic Hematoma: Peculiar Prenatal Images and Review of the Literature

Nishijima

Shukunami²,

Tsuyoshi³

et al. 2004

“…According to Blomley and Benacerraf [10], placental hemorrhage is sonographically indistinguishable from placental tumors such as chorioangiomas. On the other hand, some reports have described that the monitoring of fetal blood flow using pulse or color Doppler imaging could be useful for differential diagnosis [4,5]. In this case, reverse end-diastolic flow in the umbilical artery was observed on pulse Doppler imaging and no blood flow was observed within the placenta on color Doppler study.…”

Section: Discussionmentioning

confidence: 70%

“…Although massive subchorionic thrombohematoma is less frequent compared with placental infarction or chorioangioma [1], it causes severe IUGR due to the cirulatory disturbance of placenta [2]. All reports, describing this uncommon disease, employed mainly ultrasound analysis for its diagnosis [3,4]. Ultrasonography (USG) is a useful tool for prenatal diagnosis associated with placental abnormality, however, the observed features are comparatively similar among hematomas, cysts and other tumors.…”

Section: Introductionmentioning

confidence: 99%

A Case of Massive Subchorionic Thrombohematoma Diagnosed by Ultrasonography and Magnetic Resonance Imaging

Kojima¹,

Suzuki²,

Makino³

et al. 2000

Massive subchorionic thrombohematoma is uncommon but associated with a poor perinatal prognosis. Placental enlargement was detected in a 25-year-old Japanese primipara woman with fetal growth retardation and oligohydramnios at 23 weeks’ gestation. Ultrasonography (USG) showed an abnormal sonolucency within the placenta at 28 weeks’ gestation, but could not give an unequivocal differentiation from placental abnormalities such as hematomas, cysts and other tumors. Magnetic resonance imaging (MRI) pointed to a large hematoma in the subchorionic region. Simultaneously, the amniotic fluid was brownish colored. From these findings, it was possible to have prenatal diagnosis of massive subchorionic thrombohematoma. At 32 weeks’ gestation, the fetus died in utero and was stillborn 3 days later. Pathological findings for the placenta revealed a large hematoma diffused between the villous chorion and the chorionic plate, with wide necrosis of placental tissue, likely due to formation of multiple thrombi. The clinical and pathological findings were compatible with massive subchorionic thrombohematoma. MRI might be useful for the detection of massive subchorionic thrombohematoma and help its clinical management in combination with USG and pulse Doppler imaging.

“…subchorionic cyst, subamniotic hematoma, membranous cyst, and subchorionic thrombohematoma -have been used in the literature to describe cystic lesions in the fetal plate of the placenta [1][2][3][4][5][6] . The term subamniotic hematoma appears to have been used to describe a different lesion [4,7] , and it is uncertain whether the term massive subchorionic thrombohematomas [8] is within the spectrum of the same lesion.…”

Section: Discussionmentioning

confidence: 99%

Prenatal Diagnosis of a Large Subchorionic Placental Cyst with Intracystic Hematomas

Hong¹,

Yoo²,

Kim³

et al. 2007

A large intrauterine cyst containing a heterogenous mass was found by ultrasound in the placenta of a 35-year-old gravida 2 para 1 woman. The cyst, measuring 10.9 × 10.1 cm with a heterogenous mass shadow, was attached near the placental cord insertion site. The woman delivered a healthy female baby weighing 3,330 g by cesarean section without complication. A histopathological examination revealed that the lesion was a subchorionic cyst and contained an internal hematoma. Large subchorionic cysts are extremely rare, and secondary hemorrhage within the cyst has not been reported. In this article, we report the case of a woman with a large subchorionic cyst complicated by an intracystic hematoma and review its clinical significance.