Department of Obstetrics and Gynecology, the Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325027, China.
Department of Obstetrics and Gynecology, the Wenzhou Third Clinical Institute Affiliated to Wenzhou Medical University, Wenzhou, 325000, China.
BMC Pregnancy Childbirth. 2023 Aug 2;23(1):555. doi: 10.1186/s12884-023-05831-y.
The purpose of this study was to investigate the relationship between the size and duration of asymptomatic subchorionic hematoma and pregnancy outcomes in women with singleton pregnancies.
This was a retrospective study that enrolled 701 singleton pregnant women who were diagnosed with asymptomatic subchorionic hematoma by ultrasound at 5-10 gestational weeks. The control group recruited 640 normal pregnant women without subchorionic hematoma who were matched with subchorionic hematoma group on baseline characteristics. The pregnancy outcomes were compared between the two groups, and the associations of the size and duration of subchorionic hematoma with pregnancy outcomes were analyzed by logistic regression model.
Compared with the normal pregnancy group, the incidence of, gestational diabetes mellitus, gestational thrombocytopenia, placenta adhesion, fetal growth restriction, macrosomia in subchorionic hematoma group were higher (all P < 0.05). After adjusting for confounding factors, the hematoma size was positively associated with the occurrence of gestational hypothyroidism (adjusted OR[95%CI]: 1.029[1.004-1.054]), intrahepatic cholestasis of pregnancy (adjusted OR[95%CI]: 1.095[1.047-1.146]), term premature rupture of membranes (adjusted OR[95%CI]: 1.044[1.005-1.085]), hypertensive disorders of pregnancy (adjusted OR[95%CI]: 1.030[1.0004-1.060]), gestational thrombocytopenia (adjusted OR[95%CI]: 1.078 [1.045-1.113]), placenta adhesion (adjusted OR[95%CI]: 1.054 [1.027-1.082]), and the duration of hematoma was positively associated with the incidence of term premature rupture of membranes (adjusted OR[95%CI]: 1.070[1.027-1.115]), gestational diabetes mellitus (adjusted OR[95%CI]: 1.938 [1.886-1.993]) and fetal growth restriction (adjusted OR[95%CI]: 1.194 [1.124-1.268]).
The presence, size and duration of a first-trimester asymptomatic subchorionic hematoma may be associated with adverse pregnancy outcomes at later gestations such as term premature rupture of membranes and fetal growth restriction.
本研究旨在探讨在伴有单胎妊娠的女性中，无症状性绒毛膜下血肿的大小和持续时间与妊娠结局的关系。
这是一项回顾性研究，共纳入了 701 例在妊娠 5-10 周时经超声诊断为无症状性绒毛膜下血肿的单胎妊娠妇女。对照组招募了 640 例无绒毛膜下血肿的正常妊娠妇女，按照基线特征与绒毛膜下血肿组相匹配。比较两组的妊娠结局，并通过 logistic 回归模型分析绒毛膜下血肿的大小和持续时间与妊娠结局的关系。
与正常妊娠组相比，绒毛膜下血肿组的妊娠期糖尿病、妊娠期血小板减少症、胎盘粘连、胎儿生长受限、巨大儿的发生率更高（均 P<0.05）。在调整混杂因素后，血肿大小与妊娠期甲状腺功能减退症（调整后的 OR[95%CI]：1.029[1.004-1.054]）、妊娠肝内胆汁淤积症（调整后的 OR[95%CI]：1.095[1.047-1.146]）、足月胎膜早破（调整后的 OR[95%CI]：1.044[1.005-1.085]）、妊娠期高血压疾病（调整后的 OR[95%CI]：1.030[1.0004-1.060]）、妊娠期血小板减少症（调整后的 OR[95%CI]：1.078[1.045-1.113]）、胎盘粘连（调整后的 OR[95%CI]：1.054[1.027-1.082]）的发生呈正相关，血肿持续时间与足月胎膜早破（调整后的 OR[95%CI]：1.070[1.027-1.115]）、妊娠期糖尿病（调整后的 OR[95%CI]：1.938[1.886-1.993]）和胎儿生长受限（调整后的 OR[95%CI]：1.194[1.124-1.268]）的发生率呈正相关。
早孕期无症状性绒毛膜下血肿的存在、大小和持续时间可能与晚期妊娠的不良结局有关，如足月胎膜早破和胎儿生长受限。
