Abu-Yousef M M, Bleicher J J, Williamson R A, Weiner C P
AJR Am J Roentgenol. 1987 Oct;149(4):737-40. doi: 10.2214/ajr.149.4.737.
Twenty-one pregnancies with sonographic evidence of subchorionic hemorrhage were evaluated clinically and sonographically. Clinical evaluation included maternal age, gravidity, parity, gestational age, presence of pain, presence and amount of bleeding, and pregnancy outcome. Sonographic evaluation included the relative and absolute size of the hematoma, its echogenicity and location in relation to the placenta, the presence of marginal placental abruption, and progress on follow-up examinations. The outcome of these pregnancies was unfavorable in 15 cases (71%) and correlated well with the relative and absolute size of the hematoma, severity of vaginal bleeding, change in hematoma size on follow-up examination, and presence of pain. There was no significant correlation between the outcome and the echogenicity of the hematoma, presence of placental margin elevation, gestational and maternal age, gravidity, or parity. All hematomas extended to the margin of the placenta. Subchorionic hemorrhage is a frequent cause of first and second trimester bleeding and has a grave prognosis. Familiarity with the varied sonographic appearances and meticulous sonographic examination with special attention to the placental margins can be helpful in the diagnosis.
对21例经超声检查证实有绒毛膜下出血的妊娠病例进行了临床和超声评估。临床评估包括产妇年龄、孕次、产次、孕周、是否有疼痛、出血情况及妊娠结局。超声评估包括血肿的相对大小和绝对大小、其回声特性、相对于胎盘的位置、边缘性胎盘早剥的情况以及随访检查的进展。这些妊娠中有15例（71%）结局不佳，且与血肿的相对大小和绝对大小、阴道出血的严重程度、随访检查时血肿大小的变化以及是否有疼痛密切相关。结局与血肿的回声特性、胎盘边缘抬高情况、孕周和产妇年龄、孕次或产次之间无显著相关性。所有血肿均延伸至胎盘边缘。绒毛膜下出血是孕早期和孕中期出血的常见原因，预后严重。熟悉各种超声表现并进行细致的超声检查，特别注意胎盘边缘，有助于诊断。
