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The impact of first-trimester intrauterine hematoma on adverse perinatal outcomes
Alberto Borges Peixoto,Edward Araujo Júnior,Taciana Mara Rodrigues da Cunha Caldas,Caetano Galvão Petrini,Ana Cecília Palma Romero,Luciano Eliziário Borges Júnior,Wellington P. Martins 대한초음파의학회 2018 ULTRASONOGRAPHY Vol.37 No.4
Purpose: The aim of this study was to evaluate whether the presence of an intrauterinehematoma (IUH) on an early pregnancy ultrasound scan showing a live fetus was related toadverse perinatal outcomes. Methods: We performed a retrospective cohort study to evaluate pregnant women whounderwent an ultrasound examination in early pregnancy, between 6 weeks 0 days and 10weeks 6 days. We compared the perinatal outcomes between women with and without firsttrimester IUH using the Mann-Whitney and Fisher exact tests. Furthermore, we performed astepwise regression analysis to identify possible predictors of miscarriage among maternalcharacteristics, ultrasound parameters, and IUH. Results: During the study period, data from 783 pregnancies were included, and the incidence ofIUH was 4.5% (35 of 783). We observed a higher proportion of miscarriage following the scan(28.6% vs. 10%, P=0.003) and a larger yolk sac diameter during the scan (4.8 mm vs. 3.8 mm,P<0.001) in the pregnant women with first-trimester IUH. There was no significant differenceregard the prevalence of low birth weight (LBW; P=0.091), very LBW (P=0.370), or extremelyLBW (P=0.600) between cases with IUH and without IUH, the cesarean section rate (68% vs. 81%, P=0.130), preterm delivery (16% vs. 16%, P>0.999), or the incidence of first-trimestervaginal bleeding (31% vs. 20%, P=0.130). Moreover, heart rate (HR) was the only variable thatpredicted miscarriage with statistical significance (P=0.017). Conclusion: Women with first-trimester IUH had a higher risk of miscarriage after the ultrasoundscan. HR was the only variable that predicted miscarriage with statistical significance.
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