Outcome of First Trimester Threatened Miscarriage with or without Subchorionic Hematoma

Abstract

Abstract:Background: Subchorionic hematoma in the first trimester of the pregnancy increases the risk of spontaneous miscarriage. The risk increases with increasing maternal age, BMI, earlier gestational age (less than 9 weeks) and hematoma size. Parity and placental site do not significantly increase the risk of miscarriage.Objective: To study the significance of subchorionic hematoma finding on outcomes of the first trimester threatened miscarriage.Patients and Methods: This prospective cohort study was conducted on 144 pregnant ladies, 75women had Subchorionic hematoma (study group) matching with 69 women without Subchorionic hematoma (control group). The demographic feature, placental site, size of hematoma and pregnancy outcomes were analyzed. Results: The results showed that there was a significant association between the average age of pregnant ladies who presented with subchorionic hematoma( were the ladies presented with subchorionic hematoma is significantly older (31.17 ± 2.785) than those without a hematoma (23.50 ± 3.241), p<0.05), between the body mass index and subchorionic hematoma ( the body mass index of first group is significantly more than those of the second group , ( 31.50 ± 1.738) vs. (28.75 ± 1.710) , p value <0.05), between the gestational age of presentation and subchorionic hematoma ( in the first group (8.07 ± 1.07 weeks) versus (11.09 ± 0.8 weeks) in with no hematoma group , p value <0.05), and between the hematoma size and miscarriage. 5.3% of cases with small subchorionic hematoma underwent miscarriage versus 76.8% continued beyond the 24 weeks while 26.3% of cases with medium sized subchorionic hematoma underwent miscarriage versus 14.3, and 68.4% of large subchorionic hematoma cases underwent miscarriage versus 8.9%, with a p <0.05. The results showed that there was no statistically significant difference in parity between the two groups. Para 1 to 2 was 62.7% in the subchorionic hematoma group versus 50.7% in the no hematoma group , and Para 3 to 4 was 37.3 % in the subchorionic hematoma group versus 49.3 % in the no hematoma group, with a p value >0.05, and no statistically significant difference in the placental site between the two groups, the placenta was anterior in 52% of the subchorionic hematoma group versus 63.8% in the no hematoma group, and it was posterior in 48% in the subchorionic hematoma group versus 36.2% in the no hematoma group with a p = 0.153 . Conclusion: Subchorionic hematoma in the first trimester of the pregnancy increases the risk of spontaneous miscarriage.