The features of the fetoplacental complex in women with retrochorial hematomas in the I trimester of pregnancy

Abstract

The problem of placental dysfunction is one of the most important in modern obstetrics. Pregnant women with retrochorial hematomas (RCH) in the I trimester are at risk of placental pathology development, which leads to appearance of other negative obstetrical and perinatal pregnancy outcomes. The objective: to study the parameters of the fetoplacental complex in pregnant women with various forms of RCH based on the data of instrumental examinations. Materials and methods. The study included 140 pregnant women with RCH which appeared from 6 weeks of gestation till delivery: 60 women with recurrent RCH (1st group); 50 pregnant women, in whom RCH was diagnosed only in the early terms of gestation – 6–12 weeks included (2nd group), and 30 prospectively examined patients with uncomplicated pregnancy, without significant extragenital pathology and negative factors in the obstetrical and gynecological history (control group). Results. The frequency of placental dysfunction in recurrent RCH was 70.0%, in primary RCH – 30.0%; the level of early forms (up to 32 weeks) of fetal development retardation in the 1st group was 65.0%, with a significant prevalence of 2nd-3rd degree – 23.3%. Premature maturation of the placenta in recurrent RCH was found in 33.3% of cases, in primary form – in 16.0%. Echo-signs of mesenchymal dysplasia and heterogeneity of the placenta were found in 11.7% and 4.0% of women of the 1st and 2nd groups, respectively. With recurrent RCH, the frequency of oligohydramnios was 16.7% versus 4.0% – with primary RCH; blood flow disorders were diagnosed in 23.3% and 6.0% of cases. In 5.0% of patients of the 1st group, decompensated placental dysfunction with the development of acute fetal distress was diagnosed. Conclusions. In women with retrochorial hematomas in the I trimester of pregnancy, the course of pregnancy is characterized by disorders in the fetoplacental complex, which are more pronounced by recurrence of hematomas.