An Analysis Of Pregnancy Outcomes For The Threatened Abortion Complicated With Subchorionic Hematoma

Objective:To determine the effects of subchorionic hematoma size,gestational age,maternal age,and bleeding time on pregnancy outcome.Methods:.A retrospective review was performed with ultrasound images obtained in 86 patients with subchorionic hematoma,in order to investigate the influence of subchorionic hematoma on the pregancy outcome.All of theses cases were treated in the obstetric department of Shandong Provincial Hospital and have been followed up between January 2002 and Apirl 2008.Results:1.The average occurring time of threatened abortion with subchorionic hematoma were 15.0±4.6 gestational weeks,and the earliest one was the 7⁺³ gestational week,the lastest one was the 27⁺² gestational week.The main clinical manifestations of subchorionic hematoma were vaginal bleeding(100%)and abdominal pain(23.3%).The pregnant results included 22 cases of abortion (25.58%),4 cases of premature delivery(4.65%),4 cases of of fetal death(4.56%),56 cases of mature pregnancy(65.12%) in which there were 1case complicated with IUGR.2.There were 18 cases of hematoma which were happened in the first-trimester.The pregnant results included 6 cases of abortion(33.33%),4 cases of of fetal death(22.22%),8 cases of mature pregnancy(44.44%).There were 68 cases of hematoma which were happened in the second-trimester.The pregnant results included 8 cases of abortion(23.53%),2 cases of premature delivery(5.88%),48 cases of mature pregnancy(70.59%).3.There were 24 cases which the bleeding time lasted more than 14 days.The pregnant results included 8 cases of abortion(33.33%),4cases of premature delivery(16.67%),12 cases of mature pregnancy(50.00%).There were 62 cases which the bleeding time lasted less than 14 days.The pregnant results included 14 case of abortion(22.58%),2 cases of fetal death(6.45%),22 cases of mature pregnancy(70.97%).4.There were 10 cases whose maternal age≥35 years.The pregnant results included 2 cases of abortion(20.00%),2 cases of fetal death(20.00%),3 cases of mature pregnancy(60.00%).There were 76 cases whose maternal age＜35 years.The pregnant results included 20 cases of abortion(26.32%),4 cases of premature delivery(5.26%),2 cases of fetal death(2.63%),50 cases of mature pregnancy(65.79%).5.There were 8 cases which the hematoma volume≥60ml.The pregnant results included 4 cases of abortion(50.00%),2 cases of fetal death(25.00%),2 cases of mature pregnancy(25.00%).There were 6 cases which the hematoma volume between 60ml and 30ml.The pregnant results included 2 case of abortion(33.33%),4 cases of mature pregnancy(66.67%).There were 72 cases which the hematoma volume≤3 0ml.The pregnant results included 16 cases of abortion(22.22%),4 cases of premature delivery(5.56%),2 cases of fetal death (2.78%),50 cases of mature pregnancy(69.44%). 6.There were 22 cases which were test-tube baby.The pregnant results included 6 cases of abortion(27.27%),2 cases of premature delivery(9.09%), 14 cases of mature pregnancy(63.64%).The others were 64 cases.The pregnant results included 16 case of abortion(25.00%),2 cases of premature delivery(3.13%),4 cases of fetal death(6.25%),42 cases of mature pregnancy(65.63%).7.There were 34 cases treated by chinese medicine.The pregnant results included 10 case of abortion(29.41%),4 cases of premature delivery(11.77%),2 cases of fetal death(5.88%),18 cases of mature pregnancy(52.94%).There also have 52 cases which were not treated by chinese medicine.The pregnant results included 12 cases of abortion (23.08%),2 cases of fetal death(3.85%),38 cases of mature pregnancy(73.08%).Conclusion:If the subchorionic hematoma occur late and small,the pregnancy usually have good outcome.And the shorter of the vaginal bleeding lasting,the better of the outcome becoming.There was no association between maternal age or test-tube baby at diagnosis of subchorionic hematoma and pregnancy outcome.The effects of chinese medicine in treating the subchorionic hematoma did not reach statistical significance.