ISSN 2415-3060 (print), ISSN 2522-4972 (online)
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JMBS 2022, 7(3): 87–91
https://doi.org/10.26693/jmbs07.03.087
Clinical Medicine

Analysis of Ultrasound Parameters in Pregnant Women with Retrochorial Hematoma

Azizova N. A.
Abstract

The purpose of the study was to determine the parameters of ultrasound examination in patients with retrochorial hematoma in the early stages of pregnancy. Materials and methods. Ultrasound examination was performed in 210 women in the early stages of pregnancy to study the features of the echographic parameters of embryo development during the formation of retrochorial hematoma. The main group consisted of 100 pregnant women with signs of early termination and diagnosed retrochorial hematoma. The comparison group consisted of 80 pregnant women with the threat of early termination, but without retrochorial hematoma. The control group included 30 conditionally healthy women with a physiological course of pregnancy. All groups were comparable in age and parity. During ultrasound scanning in the first trimester, the localization of the fetal egg, its size, thickness and echogenicity of the chorion, the diameter of the yolk sac and the echogenicity of its walls were evaluated, attention was paid to the location, volume, and duration of hematoma manifestation. Results and discussion. Pregnant women with the threat of termination at the time of examination had clinical signs of threatening miscarriage. In the women of the main group with the formation of retrochorial hematoma in the first trimester, a certain clinical picture was observed: in 85.0% of cases – pain syndrome, in 71.0% – increased uterine tone and in 42.0% of cases – episodes of bloody discharge. In patients of the comparison group with the threat of termination of pregnancy, but without the formation of retrochorial hematoma, the incidence of pain syndrome was 86.3%, increased uterine tone – 77.5%, bleeding from the genital tract – 46.3%. Pregnant women with retrochorial hematoma have a higher incidence of pathology of extraembryonic formations (chorion, yolk sac). Prognostically unfavorable ultrasound signs are the formation of a retrochorial hematoma up to 6 weeks, a delay in coccygeal-parietal size of the embryo for more than 7 days, corporeal localization and a large volume of hematoma, a violation of uterine blood flow. Normal uterine blood flow was observed in all women of the control group. In patients of the comparison group, blood flow disorders were recorded in 29 (37.2%) women (p=0.000). In the main group of patients with retrochorial hematoma, uterine blood flow disorders were noted in 60 (60.0%) women (p=0.000). Conclusion. Pregnant women with retrochorial hematoma in the first trimester have a higher incidence of pathology of extraembryonic formations (chorion, yolk sac). Prognostically unfavorable ultrasound signs are the formation of a retrochorial hematoma up to 6 weeks, a delay in coccygeal-parietal size of the embryo for more than 7 days, corporeal localization and a large volume of hematoma, a violation of uterine blood flow

Keywords: pregnancy, retrochorial hematoma, ultrasound examination

Full text: PDF (Eng) 257K

References
  1. Volkova EV. Techenye beremennosty, oslozhnennoe retrokhoryalnoy gematomoy v pervom trymestre [The course of pregnancy complicated by retrochorionic hematoma in the first trimester]. Farmateka. 2016;12:53-55. [Russian]
  2. Sultangadzhyeva KhG. Patogenez voznyknovenyya otsloyky khoryona y vnutrymatochnykh gematom na rannykh srokakh beremennosty: obzor sovremennykh nauchnykh dannykh [Pathogenesis of chorionic villus sampling and intrauterine hematomas in early pregnancy: a review of current scientific data]. Akusherstvo, gynekologyya y reproduktsyya. 2019;13(4):354-68. [Russian]
  3. Romanenko TG, Zhaloba GN, Staselovych LYu. Vedenye beremennosty na fone retrokhoryalnoy gematomy v I trymestre gestatsyy [Management of pregnancy on the background of retrochorionic hematoma in the first trimester of gestation]. Zdorove zhenshchyny. 2018;9(135):118. [Russian]. https://doi.org/10.15574/HW.2018.135.118
  4. Kuznetsova AA. Techenye y yskhod beremennosty pry retsydyvyruyushchey retrokhoryalnoy gematome [The course and outcome of pregnancy in relapsing retrochorionic hematoma]. Vrach. 2019;30(9):18-23. [Russian]
  5. Solieva NK, Negmatullaeva MN, Sultonova NA. Features of the Anamnesis of Women with the Threat of Miscarriage and their Role in Determining the Risk Group. Amer J Med Sci Pharmac Res. 2020;2(9):32-34. https://doi.org/10.37547/TAJMSPR/Volume02Issue09-08
  6. Sultonova NA. Peccularities of treatment of hormonal and hemostatic disorders in functioning of pregnancy in early terms. Chin J Ind Hyg Occup Dis. 2021;39(7):181-187.
  7. Bennett GL, Bromley B, Lieberman E. Subchorionic hemorrhage in firsttrimester pregnancies: prediction of pregnancy outcome with sonography. Radiology. 2016;200:803-806. PMID: 8756935. https://doi.org/10.1148/radiology.200.3.8756935
  8. Tomnyuk OM. Profilaktyka nevynoshuvannya vagitnosti ta perynatalnoyi patologiyi u zhinok iz antyfosfolipidnym syndromom ta retrokhorialnoyu gematomoyu [Prevention of miscarriage and perinatal pathology in women with antiphospholipid syndrome and retrochorial hematoma]. Reproduktyvnoe zdorove zhenshchyny. 2020;3(43):36-39. [Ukrainian]
  9. Yonova KV, Malgyna GB, Tretyakova TB. Sovremennye predstavlenyya o vnutrymatochnykh gematomakh v I trymestre beremennosty: etyopatogenez y perynatalnye yskhody [Modern ideas about intrauterine hematomas in the first trimester of pregnancy: etiopathogenesis and perinatal outcome]. Lechenye y profylaktyka. 2019;9(3):33-38. [Russian]