Reproductive Medicine Center, Ningbo First Hospital, Ningbo, China.
Ann Med. 2021 Dec;53(1):841-847. doi: 10.1080/07853890.2021.1936150.
To explore the possible aetiology of subchorionic haematoma (SCH), especially its association with autoantibodies.
Early pregnant women who were detected SCH through ultrasonography were identified as the study group and those without SCH at comparable ages who visited the clinic at the same period of time were compared as the control group. Indexes of laboratory immune tests were compared between the two groups, as well as their pregnancy outcomes.
A total of 97 SCH patients and 130 control cases were recruited in this study. A higher proportion of women was detected autoantibodies in the SCH group compared with control group (45.36% vs 21.54%, = .000). Positive rates of ANA (24.74% vs 10.77%, = .005) and laboratory antiphospholipid antibodies (ACL, anti-β2 GP1 or LA) (25.77% vs 11.54%, = .005) showed significant differences between the two groups. The incidence of vaginal bleeding was significantly higher in the SCH group (43.30% vs 20.00%, = .000). While the miscarriage rates were not significantly different (17.53% vs 15.38%, = .666). And there were no significant differences in terms of preterm delivery rate, caesarean section rate, birth weight and pregnancy complications. Most SCHs (96.25%) were absorbed before 20th gestational week. In the SCH group, the average birth weight was significantly lower in women with autoantibodies. Clinical features and other pregnancy outcomes showed no significant differences between SCH patients with and without autoantibodies.
The occurrence of SCH may be associated with autoantibodies. The pregnancy outcomes were comparable between women with and without SCH.KEY MESSAGESSubchorionic haematoma (SCH) is increasingly commonly observed in early pregnancy period, but the aetiology is uncertain and the clinical significance of SCH is controversial.The occurrence of SCH may be associated with autoantibodies.The pregnancy outcomes were not significantly different between women with and without SCH.
探讨胎盘下血肿(SCH)的可能病因,尤其是其与自身抗体的关系。
通过超声检查发现 SCH 的早期妊娠妇女被确定为研究组,同期在诊所就诊的无 SCH 的年龄相当的妇女被作为对照组。比较两组实验室免疫检查指标及妊娠结局。
本研究共纳入 97 例 SCH 患者和 130 例对照病例。与对照组相比,SCH 组中检测到自身抗体的女性比例更高(45.36% vs 21.54%, = .000)。ANA(24.74% vs 10.77%, = .005)和实验室抗磷脂抗体(ACL、抗-β2 GP1 或 LA)(25.77% vs 11.54%, = .005)的阳性率在两组间存在显著差异。SCH 组阴道出血的发生率明显更高(43.30% vs 20.00%, = .000)。而流产率无显著差异(17.53% vs 15.38%, = .666)。早产率、剖宫产率、出生体重和妊娠并发症方面也无显著差异。大多数 SCH(96.25%)在 20 孕周前吸收。在 SCH 组中,自身抗体阳性的女性平均出生体重明显较低。有和无自身抗体的 SCH 患者的临床特征和其他妊娠结局无显著差异。
SCH 的发生可能与自身抗体有关。有和无 SCH 的女性的妊娠结局相当。