Association between first-trimester subchorionic hematoma detected at 6–8 weeks of gestation and pregnancy outcomes after fresh embryo transfers: a propensity score-matching cohort study

Yin, Rusha; Wang, Kaixuan; Li, Linling; Dang, Yujie; Wang, Bingyu; Sheng, Yan; Ma, Zufu; Sun, Minmin

doi:10.1007/s00404-022-06775-y

Cited by 6 publications

(9 citation statements)

References 28 publications

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“…Our data suggest that SCH presenting in the first trimester does not adversely affect neonatal outcomes, similar to the conclusions of several current studies. [7,21] However, some studies [22] have found that the presence of SCH can lead to an increased risk of small gestational age infants. At present, there is no consensus on the relationship between SCH and adverse pregnancy outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…[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. Current studies have shown that maternal immune disorders are also one of the causes of SCH.…”

Section: Introductionmentioning

confidence: 99%

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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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Section: Discussionmentioning

confidence: 99%

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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“…It was first described by Breus in 1892.Its initial description dates back to 1892 by Breus. Despite its rare occurrence, with an incidence rate between 0.03%–0.08%, [ 4 , 5 ] the associated risks are considerable, often leading to poor prognosis and being a primary reason for fetal mortality. [ 6 ] Multiple factors contribute to MTH, including prenatal hospitalization, abortion, blood transfusion, severe fetal growth restriction, intrauterine fetal death, premature delivery, premature rupture of membranes, placental abruption, oligohydramnios, pre-eclampsia, diffuse choriohemosiderosis, and neonatal lung incidence rate.…”

Section: Discussionmentioning

confidence: 99%

Sanji Peiyuan decoction combined with dydrogesterone in the treatment of massive subchorionic hematoma: A case report

Yang,

Zheng,

et al. 2023

Medicine

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Rationale: Subchorionic Hematoma, often referred to as Bruce hematoma, can lead to serious obstetric complications such as intrauterine growth restriction and fetal death, as well as early and late pregnancy miscarriage, placental abruption, and premature rupture of membranes, posing great harm to both mother and fetus. Patient concerns: At present, Western medical treatments have not shown satisfactory results, necessitating the discovery of more effective clinical treatment methods. Diagnoses: Threatened miscarriage, Subchorionic hematoma, Iron deficiency anemia (mild). Interventions: Sanji Peiyuan decoction combined with dydrogesterone. Outcomes: Following 17 days of treatment with Sanji Peiyuan decoction and oral dydrogesterone tablets, the hematoma was no longer detectable by ultrasound. The patient experienced no symptoms such as abdominal pain, bloating, or vaginal bleeding. She successfully gave birth around her due date, with both the mother and child in good health. Lessons: The combination of Sanji Peiyuan decoction and oral dydrogesterone tablets shows promising clinical efficacy in treating Massive Subchorionic Hematomas. This method merits further clinical research.

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“…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%

“…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 ]. However, Yin et al reported that the first-trimester SCH detected at 6–8 weeks of gestation was not associated with adverse pregnancy outcomes in singleton pregnancies after fresh embryo transfers [ 14 ]. The conflicting findings may be due to the differences in the sample size, the study design and the heterogeneous study population.…”

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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Association between first-trimester subchorionic hematoma detected at 6–8 weeks of gestation and pregnancy outcomes after fresh embryo transfers: a propensity score-matching cohort study

Cited by 6 publications

References 28 publications

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

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

Sanji Peiyuan decoction combined with dydrogesterone in the treatment of massive subchorionic hematoma: A case report

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

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