Large subchorionic cysts usually arise close to the placental cord insertion site (PCIS) inducing traction on the umbilical cord, impairing blood flow and favoring fetal growth restriction (FGR). Intracystic hemorrhage/hematoma is likely due to the prothrombotic properties of X cells secretion (extravillous trophoblast), which line the cyst wall. We describe a large subchorionic cyst located exactly at the PCIS, displacing the umbilical cord vessel branches running along the cyst surface. The fetus presented with FGR. At 36 weeks of gestational age, the cyst measured 7.7 cm in maximum dimension showing a partially organized hemorrhage and a peripheral laminated thrombohematoma. The patient underwent elective cesarean section as the cyst and its vessels were at high risk of rupture during labor. Recognition of large subchorionic cysts close to or at the PCIS in a growth restricted fetus with subsequent expedited delivery may avoid a fatal event.
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Association between first-trimester subchorionic hematoma and pregnancy loss before 20 weeks of gestation in singleton pregnancies.
Sci Rep
December 2024
Obstetrics and Gynecology Department, Yuyao People's Hospital, 800St Chengdong Road, Yuyao, 315400, Zhejiang, China.
To evaluate the association between a first-trimester subchorionic hematoma (SCH) and pregnancy loss before 20 weeks of gestation in singleton pregnancies. We conducted a retrospective cohort study of singleton pregnancies from January to December 2021. All patients had routine first-trimester ultrasound scans and were followed up for pregnancy outcomes.
View Article and Find Full Text PDFQuantification of the size of subchorionic hematoma causing pregnancy-related complications: a retrospective cohort study.
J Med Ultrason (2001)
October 2024
Department of Obstetrics and Gynecology, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan.
Purpose: This study aimed to establish criteria for defining "large" subchorionic hematoma (SCH) and assess its association with pregnancy complications.
Method: This was a retrospective cohort study conducted at our institution between 2019 and 2020. We compared the size of SCH between the pregnancy-related complication and non-complication groups, using two measurement methods.
Risk Factors Are Not Very Risky Once a Normal Embryonic Heart Rate is Seen in Early Pregnancy.
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September 2024
Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Article Synopsis
- The study aimed to evaluate early pregnancy outcomes when a sonogram shows a normal embryonic heart rate in the first trimester, while also analyzing how various risk factors impact those outcomes.
- Out of 6597 cases analyzed, 91.4% resulted in successful first-trimester outcomes, although the prognosis dropped slightly with risk factors such as maternal age over 35, large subchorionic hematomas, and multiple uterine fibroids.
- A normal embryonic heart rate on a first-trimester sonogram suggests a successful outcome rate of at least 83%, even when risk factors are present, and over 90% when these factors are absent.
Placental Histopathologic Findings in Fetal Hereditary Pyropoikilocytosis after Undergoing Successful Intrauterine Transfusion.
Fetal Pediatr Pathol
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Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA.
The available literature on intrauterine transfusion focuses largely on its application in fetal alloimmunization rather than hereditary red cell disorders, with limited illustration of its associated histopathologic findings. We present the histologic findings in a placenta associated with preterm delivery of an infant with autosomal mutation following multiple intrauterine transfusions, including appropriate villous maturation, subchorionic organizing hematomas, hemosiderin-laden macrophages, and dysmorphic fetal erythrocytes within villous capillaries. Intrauterine transfusion is associated with placental histologic findings that reflect procedural changes without significant disruption of placental membranes or villous maturation.
View Article and Find Full Text PDFAssociation between graded subchorionic hematoma and adverse pregnancy outcomes in singleton pregnancies: a prospective observational cohort study.
Arch Gynecol Obstet
February 2024
Department of Obstetrics and Gynecology, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
Objective: To investigate whether different grades of subchorionic hematoma (SCH) are involved in the timing of birth and the development of adverse pregnancy outcomes in singleton pregnant women.
Methods: A total of 171 women with singleton pregnancies, 72 of whom had SCH before 20 weeks and between 12 and 20 weeks of gestational age (GA), were included in this study conducted between January 2018 and December 2021. These patients were divided into three subgroups based on the size of the subchorionic hematoma on ultrasound imaging.
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