Outcome of First Trimester Threatened Miscarriage With or Without Subchorionic Hematoma

Background: Vaginal bleeding is a common problem in the first trimester, vaginal bleeding in the presence of a closed cervix and ultrasonographic visualization of an intrauterine pregnancy with positive fetal cardiac activity is diagnostic of threatened miscarriage. In patients with threatened miscarriage, vaginal bleeding does not always result in pregnancy loss. The bleeding may be a result of disrupted decidual vessels due to a separation at the subchorionic area. Objective: To study the significance of abdominal ultrasound subchorionic hematoma finding on the first trimester threatened miscarriage outcome. Patients and Methods: This prospective cohort study was conducted on 144 pregnant ladies, 75 women had Subchorionic hematoma (study group) matching with 69 women without Subchorionic hematoma (control group). The demographic feature, placental site, size of hematoma and pregnancy outcome were analyzed. Results: Analysis of data show that there is a statistically significant difference between both groups regarding maternal age, gestational age, BMI, size of the hematoma, and pregnancy outcome. Also the study shows that there is no statistically significant difference regarding parity and placental site. Conclusion: Subchorionic hematoma in the first trimester of the pregnancy increases the risk of spontaneous miscarriage. The risk increases with increasing maternal age, BMI, earlier gestational age (less than 9 weeks) and hematoma size. Parity and placental site do not significantly increase the risk of miscarriage.