Analysis of Ultrasound Parameters in Pregnant Women with Retrochorial Hematoma

Abstract

The purpose of the study was to determine the parameters of ultrasound examination in patients with retrochorial hematoma in the early stages of pregnancy. Materials and methods. Ultrasound examination was performed in 210 women in the early stages of pregnancy to study the features of the echographic parameters of embryo development during the formation of retrochorial hematoma. The main group consisted of 100 pregnant women with signs of early termination and diagnosed retrochorial hematoma. The comparison group consisted of 80 pregnant women with the threat of early termination, but without retrochorial hematoma. The control group included 30 conditionally healthy women with a physiological course of pregnancy. All groups were comparable in age and parity. During ultrasound scanning in the first trimester, the localization of the fetal egg, its size, thickness and echogenicity of the chorion, the diameter of the yolk sac and the echogenicity of its walls were evaluated, attention was paid to the location, volume, and duration of hematoma manifestation. Results and discussion. Pregnant women with the threat of termination at the time of examination had clinical signs of threatening miscarriage. In the women of the main group with the formation of retrochorial hematoma in the first trimester, a certain clinical picture was observed: in 85.0% of cases – pain syndrome, in 71.0% – increased uterine tone and in 42.0% of cases – episodes of bloody discharge. In patients of the comparison group with the threat of termination of pregnancy, but without the formation of retrochorial hematoma, the incidence of pain syndrome was 86.3%, increased uterine tone – 77.5%, bleeding from the genital tract – 46.3%. Pregnant women with retrochorial hematoma have a higher incidence of pathology of extraembryonic formations (chorion, yolk sac). Prognostically unfavorable ultrasound signs are the formation of a retrochorial hematoma up to 6 weeks, a delay in coccygeal-parietal size of the embryo for more than 7 days, corporeal localization and a large volume of hematoma, a violation of uterine blood flow. Normal uterine blood flow was observed in all women of the control group. In patients of the comparison group, blood flow disorders were recorded in 29 (37.2%) women (p=0.000). In the main group of patients with retrochorial hematoma, uterine blood flow disorders were noted in 60 (60.0%) women (p=0.000). Conclusion. Pregnant women with retrochorial hematoma in the first trimester have a higher incidence of pathology of extraembryonic formations (chorion, yolk sac). Prognostically unfavorable ultrasound signs are the formation of a retrochorial hematoma up to 6 weeks, a delay in coccygeal-parietal size of the embryo for more than 7 days, corporeal localization and a large volume of hematoma, a violation of uterine blood flow