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Retrochorial hematoma in early pregnancy

In some cases, pregnancy proceeds under the threat of miscarriage. Often, the result of such a diagnosis is a retrochorial hematoma - a collection of blood that forms between the chorion and the fetal egg. On ultrasound, it is defined as a dark spot located in the area of ​​attachment of the embryo to the fetal membrane.

Chorion is a precursor of the placenta, which will form over a period of 14-15 weeks. Up to this point, it is the villous outer membrane of the fetus, which has grown together with the epithelium of the uterus, with the result that the blood vessels of the fetus and mother are intertwined.

A hematoma is a collection of bleeding that is localized in a particular place. Retrochorial hematoma forms on the part where there had previously been a detachment of the ovum during a threatening abortion.


Causes of retrochorial hematoma during pregnancy

Causes of retrochorial hematoma during pregnancy

Retrochorial hematoma occurs in the uterus in early pregnancy, mostly up to 16-17 weeks. That is, the period of its possible occurrence coincides with the time of formation of the placenta. There may be several reasons for the formation of blood between the ovum and the chorion:

1) Hormonal failure - high testosterone and prolactin can impede the normal metabolism between the mother and the fetus - this leads to the onset of detachment. The most common cause of hormonal nature is the lack of progesterone.

To avoid the beginning of the process of separation of the ovum from the chorion, doctors prescribe the use of synthetic analogs of progestins - Duphaston and Utrogestan. In cases where the shortage of progesterone has led to extensive detachment, emergency hormone therapy is prescribed, which involves taking high doses of Duphaston at regular intervals.

2) Excessive physical exertion - overfatigue can bring the uterus to an increased tone. The longer the gestation period, the greater the likelihood that the muscles of the uterus will become tense and harden.

Spasticity can provoke detachment of the ovum and the beginning of labor. Increased tone is treated with droppers and drugs taken by mouth.

3) Exacerbation of STDs - provokes the beginning of an extensive inflammatory process not only of the uterus, but also of the pelvic organs as a whole. As a result, the network of blood vessels of the ovum is filled with blood clots, because to suppress infections, the female body begins to actively produce platelets.

The fetus stops receiving the necessary nutrition, and the chorion loses its ability to remain on the surface of the ovum. As a result, detachment begins, which creates a threat of miscarriage.

4) Excessive influence of vibration - in such cases, the threat of chorion separation is relevant only for small periods of pregnancy, up to 8 weeks. Vibration provokes a violation of the blood circulation of the ovum, the vibration waves contribute to the gradual separation of tissues.

For this reason, for a period of 3-4 weeks, doctors try not to carry out ultrasound diagnostics too often if a woman has a threat of miscarriage.

5) Diseases associated with bleeding disorders - here most often refers to patients with thrombophilia. This is a genetic disease that contributes to increased thrombosis.

It is extremely difficult for women with thrombophilia to bear a child - their pregnancy is constantly exposed to the threat of placental insufficiency and placental abruption.

Obviously, all these reasons lead to one outcome - the separation of the ovum from the chorion, which leads to the formation of retrochorial hematoma.

Signs of hematoma by ultrasound

  • Deformation of the ovum - arises from the fact that the detached edge begins to "sag". The larger the hematoma, the more irregular the fetal egg takes.
  • Thickening of the uterus - an increase in myometrium occurs on the side where there is detachment.
  • The presence of a cavity filled with blood secretions - on the monitor it is displayed as a dark spot separated from the ovum by a thin wall - the inner shell of the embryo.

Symptoms of retrochorial hematoma

A small retrochorial hematoma, as a rule, has no external manifestations, and a woman only finds out about her in the ultrasound room. More severe forms, life-threatening fetus, have the following symptoms:

  • Pulling pain in lower abdomen.
  • Bloody issues. The more abundant and brighter the blood, the more serious the detachment and hematoma.
  • Cramping pains. Usually arise when the chances of saving the child is very small.
  • The deterioration of the general condition of the pregnant: dizziness, loss of consciousness, fatigue.

When anxiety symptoms appear, an ambulance must be urgently called, because retrochorial hematoma is a pathology that represents a serious threat to the life of the fetus. The sooner the doctors succeed in stopping placental abruption, the less the volume of hematoma will be.

Consequences of retrochorial hematoma

Consequences of retrochorial hematoma

In assessing the effects of retrochorial hematoma in pregnancy on a child, the doctor determines the extent of the formation. After the cause of the threat of miscarriage is eliminated, the gynecologist will have to treat the accumulation of blood between the chorion and the fetal egg.

  • Small hematoma, up to 10% of the size of the ovum

Treatment is not subject to, as it does not pose a threat to the life of the fetus. It is gradually resolved independently, and the output of these insignificant blood secretions remains unnoticed for the expectant mother, since there are very few of them.

  • Medium hematoma, up to 35% of the size of the ovum

Being treated, is the cause of fetal hypoxia. However, the lack of oxygen is not catastrophic and does not pose a threat to the life of the fetus. In this case, only intrauterine growth of the child can be observed.

  • Extensive hematoma, over 40% of the size of the ovum

Requires urgent treatment, is a serious threat not only for development, but also for the life of the fetus. Causes severe hypoxia of the child and impaired blood circulation in the network of blood vessels of the ovum.

A woman cannot independently assess the degree of danger, so she needs to follow the doctor’s instructions. An ultrasound specialist will measure the volume of the retrochorial hematoma, and the gynecologist will decide whether there is a need for treatment.

Treatment for hematoma retrochorial hematoma

Treatment methods include taking medication and lifestyle changes. Such changes will be temporary and the need for them will disappear as soon as the retrochorial hematoma resolves.

Bed rest is indicated for extensive accumulations of blood. It is needed in order to reduce the likelihood of a high uterine tone when walking and other physical activities. The appeared spasticity of the myometrium will only aggravate the condition of the fetus and strengthen its hypoxia.

Drug therapy - involves the use of hemostatic agents such as Ditsinon, Vikasol. Depending on the severity of the hematoma, they can be given in pills or injections. Emergency situations require intramuscular administration of drugs.

Ascorutin and Vitamin C may be prescribed to strengthen the vessel walls. In addition to stopping internal bleeding, the doctor needs to prescribe placental blood flow, such as folic acid, vitamin E. If as a result of taking hemostatic drugs, the threat of FPN has occurred, then the doctor must be connected to the scheme Treatment Actovegin or Phlebodia, but with great care.

Be sure to ask the gynecologist how retrohorial hematoma comes out after treatment, because the scarce brown discharge that appears can scare future moms.

With timely successful treatment of pathology, a woman has every chance to give birth to a healthy child in due time. Therefore, when detecting accumulations of blood during the formation of the placenta, it is important to consult a doctor as soon as possible.


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