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Symptoms of an intrauterine hematoma associated with pregnancy complications: a systematic review.

Xiang L, Wei Z, Cao Y - PLoS ONE (2014)

Bottom Line: We just focused on the pregnancy outcomes associated with different symptoms of an IUH.It is generally agreed that a retroplacental, posterior or subchorionic in the fundus of uterus, and/or persistent IUH is associated with adverse outcomes in the ongoing pregnancy.Some researchers argue that a large IUH is associated with an increased risk of adverse events during pregnancy while others refuted.

View Article: PubMed Central - PubMed

Affiliation: Reproductive Medicine Center, the First Affiliated Hospital of Anhui Medical University, Hefei, China.

ABSTRACT

Objective: To evaluate the predictive value of the symptoms of an intrauterine hematoma (IUH) for adverse pregnancy outcomes.

Methods: A literature review was performed with the search terms, including intrauterine/subchorionic/retroplacental/subplacental hematoma/hemorrhage/bleeding/collection/fluid, covering the period from January, 1981 to January, 2014. We just focused on the pregnancy outcomes associated with different symptoms of an IUH.

Results: It is generally agreed that a retroplacental, posterior or subchorionic in the fundus of uterus, and/or persistent IUH is associated with adverse outcomes in the ongoing pregnancy. However, the prognosis value of both volume and gestational age at diagnosis of IUH still remains controversial. Some researchers argue that a large IUH is associated with an increased risk of adverse events during pregnancy while others refuted. It is believed by some that the earlier an IUH was detected, the higher the risk for adverse outcomes would be, while no or weak association were reported by other studies. The prognostic value of the simultaneous presence of vaginal bleeding on pregnancy outcome is also controversial.

Conclusions: Both the position relative to the placenta or uterus and duration of IUH have strong predictive value on the prognosis in the ongoing pregnancy. However, the prognostic values of the IUH volume, gestational age at diagnosis and the simultaneous presence of vaginal bleeding remain controversial up to now. Moreover, most of previous reports are small, uncontrolled studies with incomplete information. Prospective, large sample, cohorts studies which take all detailed symptoms of an IUH into consideration are needed when we evaluate its clinical significance in the prognosis of pregnancy.

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An 8-week fetus associated with a small (less than one-third of the chorionic sac circumference) subchorionic hematoma (arrows) [26].
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pone-0111676-g005: An 8-week fetus associated with a small (less than one-third of the chorionic sac circumference) subchorionic hematoma (arrows) [26].

Mentions: Of the researches enrolled in our review, most reported the association between volume of a hematoma and pregnancy outcome. The calculation algorithm of a hematoma’s volume varied in different studies and that perhaps explained their different results. The earliest and easiest definition of absolute size was the multiplied product of longitudinal, transverse, and antero-posterior diameters [3], [14]. Since the outline of most hematomas was not regular rectangle, mean of its three diameters [15], [16], half of the product [9], [17]–[20], or the product multiplied by a constant [8], [21], [22], were used by later researchers. Some authors recorded the size directly by the largest diameter or area observed [23], [24]. Another was the relative size, which could be expressed in percentage. It was calculated as the absolute size of a hematoma relative to the gestational sac size [9]. The latter seemed to be more popular in recent reports [14], [21], [25]–[28]. No matter which method was used, the standard by which IUHs were classified as small, medium, and large in volume was also discrepant among studies (Figure 5, Figure 6 and Figure 7).


Symptoms of an intrauterine hematoma associated with pregnancy complications: a systematic review.

Xiang L, Wei Z, Cao Y - PLoS ONE (2014)

An 8-week fetus associated with a small (less than one-third of the chorionic sac circumference) subchorionic hematoma (arrows) [26].
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4219764&req=5

pone-0111676-g005: An 8-week fetus associated with a small (less than one-third of the chorionic sac circumference) subchorionic hematoma (arrows) [26].
Mentions: Of the researches enrolled in our review, most reported the association between volume of a hematoma and pregnancy outcome. The calculation algorithm of a hematoma’s volume varied in different studies and that perhaps explained their different results. The earliest and easiest definition of absolute size was the multiplied product of longitudinal, transverse, and antero-posterior diameters [3], [14]. Since the outline of most hematomas was not regular rectangle, mean of its three diameters [15], [16], half of the product [9], [17]–[20], or the product multiplied by a constant [8], [21], [22], were used by later researchers. Some authors recorded the size directly by the largest diameter or area observed [23], [24]. Another was the relative size, which could be expressed in percentage. It was calculated as the absolute size of a hematoma relative to the gestational sac size [9]. The latter seemed to be more popular in recent reports [14], [21], [25]–[28]. No matter which method was used, the standard by which IUHs were classified as small, medium, and large in volume was also discrepant among studies (Figure 5, Figure 6 and Figure 7).

Bottom Line: We just focused on the pregnancy outcomes associated with different symptoms of an IUH.It is generally agreed that a retroplacental, posterior or subchorionic in the fundus of uterus, and/or persistent IUH is associated with adverse outcomes in the ongoing pregnancy.Some researchers argue that a large IUH is associated with an increased risk of adverse events during pregnancy while others refuted.

View Article: PubMed Central - PubMed

Affiliation: Reproductive Medicine Center, the First Affiliated Hospital of Anhui Medical University, Hefei, China.

ABSTRACT

Objective: To evaluate the predictive value of the symptoms of an intrauterine hematoma (IUH) for adverse pregnancy outcomes.

Methods: A literature review was performed with the search terms, including intrauterine/subchorionic/retroplacental/subplacental hematoma/hemorrhage/bleeding/collection/fluid, covering the period from January, 1981 to January, 2014. We just focused on the pregnancy outcomes associated with different symptoms of an IUH.

Results: It is generally agreed that a retroplacental, posterior or subchorionic in the fundus of uterus, and/or persistent IUH is associated with adverse outcomes in the ongoing pregnancy. However, the prognosis value of both volume and gestational age at diagnosis of IUH still remains controversial. Some researchers argue that a large IUH is associated with an increased risk of adverse events during pregnancy while others refuted. It is believed by some that the earlier an IUH was detected, the higher the risk for adverse outcomes would be, while no or weak association were reported by other studies. The prognostic value of the simultaneous presence of vaginal bleeding on pregnancy outcome is also controversial.

Conclusions: Both the position relative to the placenta or uterus and duration of IUH have strong predictive value on the prognosis in the ongoing pregnancy. However, the prognostic values of the IUH volume, gestational age at diagnosis and the simultaneous presence of vaginal bleeding remain controversial up to now. Moreover, most of previous reports are small, uncontrolled studies with incomplete information. Prospective, large sample, cohorts studies which take all detailed symptoms of an IUH into consideration are needed when we evaluate its clinical significance in the prognosis of pregnancy.

Show MeSH
Related in: MedlinePlus