Retrospective study of pregnant women placed under expectant management for persistent hemorrhage

Arch Gynecol Obstet. 2014 Feb;289(2):307-11. doi: 10.1007/s00404-013-2972-z. Epub 2013 Jul 26.

Abstract

Objective: To examine the clinicopathological characteristics of pregnant women who presented with intermittent hemorrhage occurring throughout pregnancy until delivery.

Method: A total of 24 women with intermittent hemorrhage occurring throughout pregnancy were categorized into two groups, a group with persistent subchorionic hematoma (PSH) and another with chronic abruption (CA), and the pregnancy outcomes were compared between the two groups. The data were expressed as medians (range).

Results: There were 18 women in the PSH group and 6 women in the CA group. The median gestational age at delivery was 27.9 (22.1-33.4) weeks in the PSH group and 32.9 (24.3-33.1) weeks in the CA group, revealing a significantly earlier gestational age at delivery in the former group (p = 0.014). The percentage of the women developing acute abruption tended to be higher in the CA group [66.7 % (4/6)] than in the PSH group [26.3 % (5/18)]. Small for gestational age (SGA) infants and neonatal chronic lung disease were seen at high incidences, but only in the PSH group [21.1 % (4/18) and 42.1 % (8/18), respectively].

Conclusion: PSH was associated with earlier gestational age at delivery, a higher incidence of SGA infants, and poorer pregnancy outcomes than CA.

MeSH terms

  • Adult
  • Delivery, Obstetric
  • Female
  • Gestational Age
  • Hematoma / epidemiology
  • Hematoma / etiology
  • Hematoma / therapy*
  • Humans
  • Infant, Small for Gestational Age
  • Japan / epidemiology
  • Pregnancy
  • Pregnancy Complications, Hematologic / epidemiology
  • Pregnancy Complications, Hematologic / etiology
  • Pregnancy Complications, Hematologic / therapy*
  • Pregnancy Outcome
  • Retrospective Studies
  • Risk Factors
  • Uterine Hemorrhage / epidemiology
  • Uterine Hemorrhage / etiology
  • Uterine Hemorrhage / therapy*
  • Watchful Waiting*