Subchorionic hemorrhage: sonographic diagnosis and clinical significance

Abu‐Yousef, Monzer M.; Bleicher, JJ; Williamson, R A; Weiner, C

doi:10.2214/ajr.149.4.737

Cited by 62 publications

(42 citation statements)

References 6 publications

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“…2 The overall abortion rate of 20.7% in this study is similar to that found by Goldstein et al 1 and Jouppila, 13 but much higher than those reported by others in patients with threatened abortion. 2,4,10,15,16 On the other hand, it is much less than that found by Abu-Yousef et al 6 This wide variation in the abortion rates, from 0.0% to 43.8%, can best be explained in part by the rather small numbers of patients in most of these studies, some of which may also have an overrepresentation of high-risk pregnancies. However, variation in populations studied may also be a major factor in the divergent findings.…”

Section: Discussionmentioning

confidence: 64%

“…The natural worry of women with threatened abortion is the loss of their pregnancies, and in about 30% to 50% of cases, that fear may be justifiable. 5,6 The symptoms and signs of threatened abortion are so variable that the outcome of the pregnancy cannot be reliably predicted by the clinical features at presentation. 7 Thus, various biochemical and biophysical tests have been applied extensively in attempts to improve the accuracy of predicting the outcome of these pregnancies.…”

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confidence: 99%

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Subchorionic Hematoma in Threatened Abortion: Sonographic Evaluation and Significance

Al-Nuaim

Adelusi

1996

Ann Saudi Med

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In a study of 92 women with subchorionic hematoma evaluated with sonographic scan in King Khalid University Hospital, it was found that the mean ages and live births of patients who carried their pregnancies to viability were higher when compared with the patients who aborted. There was a statistically significant association between the gestational age at diagnosis of subchorionic hematoma and the size of the hematoma. There was, however, no statistically significant association found between the gestational age at diagnosis, size and site of the hematoma and the outcome of pregnancy. It was concluded that subchorionic hematoma which appear either in the second trimester, or are larger, or located in the lower uterine segment, may be associated with higher rates of abortion or preterm deliveries. Nevertheless, there is no statistically significant impact of these on the outcome of pregnancy. Ann Saudi Med 1996;16(6):650-653. L Al-Nuaim, N Chowdhury, B Adelusi, Subchorionic Hematoma in Threatened Abortion: Sonographic Evaluation and Significance. 1996; 16(6): 650-653 Vaginal bleeding, one of the features of early pregnancy miscarriage, occurs in up to 25% of all pregnancies, 1-3 although the reported incidence of at least 16% of clinically recognized pregnancies, quoted by Hertig and Livingstone 4 some 50 years ago, is probably still correct today. The natural worry of women with threatened abortion is the loss of their pregnancies, and in about 30% to 50% of cases, that fear may be justifiable. 5,6 The symptoms and signs of threatened abortion are so variable that the outcome of the pregnancy cannot be reliably predicted by the clinical features at presentation. 7 Thus, various biochemical and biophysical tests have been applied extensively in attempts to improve the accuracy of predicting the outcome of these pregnancies. [8][9][10] At present there is no single test that can accurately determine outcome of pregnancy after threatened abortions. However, ultrasonic examination has revolutionized clinical practice by providing definite evidence of the viability of a pregnancy as early as six weeks. 1,10,11 One of the sonographic features used in the evaluation of fetal viability in early pregnancy is the presence of subchorionic hematoma, which appears to have gained some prominence lately. 1-3,10-13 Indeed, it has been suggested that this can be used to predict the outcome of pregnancy when correlated with fetal activities such as motion and cardiac function. 1 We present here a prospective study of the ultrasonographic evaluation of patients with vaginal bleeding in early and second trimester of pregnancy, to determine the gestational age at diagnosis of, and the size and site of subchorionic hematoma, and to correlate these with pregnancy outcome. Material and MethodsDuring the period September 1992 to August 1994, 1082 pregnant patients who had completed between six and 23 weeks of gestation, as based on sonographic estimation of age using the crown-rump length (CRL) or biparietal diameter (BPD), were ...

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Section: Discussionmentioning

confidence: 64%

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confidence: 99%

Subchorionic Hematoma in Threatened Abortion: Sonographic Evaluation and Significance

Al-Nuaim

Adelusi

1996

Ann Saudi Med

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“…Increased angiogenesis to ensure maintenance of the developing fetus is a hallmark of all pregnancies (70). Subchorionic hematoma, separation of the chorion from the endometrium, permits maternal blood leakage and pooling within the placenta/placentome during pregnancy (71,72). In addition, the normal events associated with blastocyst implantation in hemochorial placentation, i.e., remodeling of the maternal decidua (67), directly expose the fetal trophectoderm to maternal blood.…”

Section: Discussionmentioning

confidence: 99%

Infectious Prions in the Pregnancy Microenvironment of Chronic Wasting Disease-Infected Reeves' Muntjac Deer

Nalls

McNulty

Hoover

et al. 2017

J Virol

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Ample evidence exists for the presence of infectious agents at the maternal-fetal interface, often with grave outcomes to the developing fetus (i.e., Zika virus, brucella, cytomegalovirus, and toxoplasma). While less studied, pregnancyrelated transmissible spongiform encephalopathies (TSEs) have been implicated in several species, including humans. Our previous work has shown that prions can be transferred from mother to offspring, resulting in the development of clinical TSE disease in offspring born to muntjac dams infected with chronic wasting disease (CWD) (1). We further demonstrated protein misfolding cyclic amplification (PMCA)-competent prions within the female reproductive tract and in fetal tissues harvested from CWD experimentally and naturally exposed cervids (1, 2). To assess whether the PMCA-competent prions residing at the maternal-fetal interface were infectious and to determine if the real-time quaking-induced conversion (RT-QuIC) methodology may enhance our ability to detect amyloid fibrils within the pregnancy microenvironment, we employed a mouse bioassay and RT-QuIC. In this study, we have demonstrated RT-QuIC seeding activity in uterus, placentome, ovary, and amniotic fluid but not in allantoic fluids harvested from CWD-infected Reeves' muntjac dams showing clinical signs of infection (clinically CWD-infected) and in some placentomes from pre-clinically CWD-infected dams. Prion infectivity was confirmed within the uterus, amniotic fluid, and the placentome, the semipermeable interface that sustains the developing fetus, of CWD-infected dams. This is the first report of prion infectivity within the cervid pregnancy microenvironment, revealing a source of fetal CWD exposure prior to the birthing process, maternal grooming, or encounters with contaminated environments.IMPORTANCE The facile dissemination of chronic wasting disease within captive and free-range cervid populations has led to questions regarding the transmission dynamics of this disease. Direct contact with infected animals and indirect contact with infectious prions in bodily fluids and contaminated environments are suspected to explain the majority of this transmission. A third mode of transmission, from mother to offspring, may be underappreciated. The presence of pregnancyrelated prion infectivity within the uterus, amniotic fluid, and the placental structure reveals that the developing fetus is exposed to a source of prions long before exposure to the infectious agent during and after the birthing process or via contact with contaminated environments. These findings have impact on our current concept of CWD disease transmission.KEYWORDS CWD, maternal, pregnancy, prions T ransmissible spongiform encephalopathies (TSEs), or prion diseases, are proteinaceous infectious neurodegenerative diseases affecting animals, including humans (3, 4). The disease is caused by the accumulation of an aberrant misfolded form

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“…Vaginal bleeding occurs in 25% of pregnancies in the first 20 weeks, and half of these result in miscarriage (16). Hence, it is important to identify the risk factors of threatened abortion and the factors that can affect the outcome.…”

Section: Discussionmentioning

confidence: 99%

“…However, according to the results of a recent meta-analysis, the presence of SCH increases the risk of early or late pregnancy loss by 2-fold (15). It is suggested that the presence of SCH increases the risk of an adverse obs-tetric outcome, and fetal outcome is associated with the size of the hematoma, maternal age, and gestational age (16,17). The aim of the present retrospective cohort study was to assess the effects of ultrasonographically detected SCH on pregnancy outcomes in patients with vaginal bleeding within the first half of pregnancy.…”

Section: Introductionmentioning

confidence: 99%

The effects of subchorionic hematoma on pregnancy outcome in patients with threatened abortion

Şükür¹,

Göç²,

Köse³

et al. 2014

J Turkish German Gynecol Assoc

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Objective:To assess the effects of ultrasonographically detected subchorionic hematomas on pregnancy outcomes in patients with vaginal bleeding within the first half of pregnancy. Material and Methods:Patients diagnosed with threatened abortion due to painless vaginal bleeding and who were followed up in an inpatient service during the first vaginal bleeding between January 2009 and December 2010 were included in this retrospective cohort study. Patients were divided into two groups according to the presence of subchorionic hematoma. Miscarriage rates and pregnancy outcomes of ongoing pregnancies were compared between the groups.Results: There were no statistically significant differences between the groups regarding demographic parameters, including age, parity, previous miscarriage history, and gestational age at first vaginal bleeding. While 13 of 44 pregnancies (29.5%) with subchorionic hematoma resulted in miscarriage, 25 of 198 pregnancies (12.6%) without subchorionic hematoma resulted in miscarriage (p=.010). The gestational age at miscarriage and the duration between first vaginal bleeding and miscarriage were similar between the groups. The outcome measures of ongoing pregnancies, such as gestational week at delivery, birth weight, and delivery route, were also similar between the groups. Conclusion:Ultrasonographically detected subchorionic hematoma increases the risk of miscarriage in patients with vaginal bleeding and threatened abortion during the first 20 weeks of gestation. However, it does not affect the pregnancy outcome measures of ongoing pregnancies. (J Turk Ger Gynecol Assoc 2014; 15: 239-42) Key words: Abortion, threatened, miscarriage, spontaneous, pregnancy outcome Received: 02 September, 2014 Accepted: 09 October, 2014 The effects of subchorionic hematoma on pregnancy outcome in patients with threatened abortion

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Subchorionic hemorrhage: sonographic diagnosis and clinical significance

Cited by 62 publications

References 6 publications

Subchorionic Hematoma in Threatened Abortion: Sonographic Evaluation and Significance

Subchorionic Hematoma in Threatened Abortion: Sonographic Evaluation and Significance

Infectious Prions in the Pregnancy Microenvironment of Chronic Wasting Disease-Infected Reeves' Muntjac Deer

The effects of subchorionic hematoma on pregnancy outcome in patients with threatened abortion

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