The Effects of Subchorionic Hematoma on Pregnancy Outcome in Patients with Threatened abortion
Objective: To find out the association of Subchorionic Hematoma with pregnancy outcome in patients with threatened abortion.
Place and duration of study: This case control study was carried out at obstetrics and gynecology department of Azad Jammu And Kashmir Medical College, Muzaffarabad from April 2018 to March 2019.
Methodology: All the patients presenting with threatened abortion that is vaginal bleeding in first trimester and fulfilling inclusion and exclusion criteria were included in the study. These patients were divided into two groups of cases with subchorionic hematoma and controls without findings of hematoma. The presence, size and location of subchorionic hematoma was assessed by ultrasound in all women in the study. The presence of crescent shaped, echo free area between the myometrium and chorionic membrane was taken as subchorionic hematoma. All this information along with demographic and clinical examination findings were noted on a predesigned performa.
Results: The mean age of cases was 30.71 ± 5.15 years and controls was 29.44 ± 3.45 years. The mean gestational age at first vaginal bleeding was recorded significantly (p-value < 0.05) higher among cases group (11.76 ± 3.42 vs. 10.52 ± 1.62). A significant (p-value < 0.05) association of subchorionic hematoma with miscarriage was observed indicating a higher rate of miscarriage in cases group (37.9% vs. 19.7%) compared to control group. The pregnancy complications like IUGR, pregnancy induced hypertension (PIH) and preterm labor did not show any association with subchorionic hematoma except preeclampsia rate (15.2% vs. 4.5%). Caesarean section rate was significantly (p-value < 0.05) higher in cases group (43.9% vs. 20.0%). The rate of good APGAR score (> 7) was observed significantly lower in cases group (63.4% vs. 82.2%, p-value < 0.05).
Conclusion: The risk of miscarriage may increase in patients with subchorionic hematoma presenting with threatened abortion. The presence of subchorionic hematoma increase the chances of adverse pregnancy outcome.
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