Prediction of gestation in women with a terminated pregnancy
and the presence of subchorial hematoma is one of the promising
directions for the optimal realization of reproductive potential. The
aim of the work was to determine the significance of the dynamics
of the size of the subchorial hematoma and the qualitative features
of blood flow in this area for predicting gestation.
A study was conducted of 90 pregnant women with clinical
manifestations of the begun abortion in the period from 10 to 16
weeks of pregnancy and the presence of subchorial hematoma.
All pregnant women received gestagens: dihydrosterone 20-
40mg per os daily (54 people) or micronized progesterone 400-
600mg vaginally (36 people). Upon admission to the hospital and
upon discharge from the hospital, hematoma sizes (conditional
area) were determined and blood flow was estimated in the area
of the hematoma projection or the zone of its previous location.
Doppler blood flow assessment was carried out according to three
qualitative features: diffuse blood flow - restored, lacunar (lake) -
partially restored and blocked - lack of blood flow. The presence
of systole and diastole was regarded as physiological blood flow.
Definition of only diastole was characterized as partial restoration
and inferiority of blood flow.
After the initiation of treatment, clinical improvement
(disappearance of a lower abdomen) occurred in all women on the
first day, and the disappearance of the clinical manifestations of
abortion (spotting from the vagina) by 3-4 days.
Decrease in the hematoma conditional area after completion
of treatment in 40 (44.4%) people, complete resorption of the
hematoma in 10 (11.1%) women, in 38 (42.2%) hematoma sizes
remained unchanged, and in 2 (2.2%) it even increased slightly. The
hematoma area on average decreased by 38.7±1.1%. According to
Dopplerometry, restoration of blood flow occurred in 57 (63.3%)
women, partial recovery in 28 (31.1%) and blocked blood flow
remained in 5 (5.6%) pregnant women, but who did not have a
clinic for the threat of termination of pregnancy.
Until the end of pregnancy, only 76 pregnant women were
tracked. Of which 58 (76.3%) were reported before the gestational
age, while asymmetric mild IUGR was detected only in 4 (7.1%)
newborns. Premature pregnancy at 32-36 weeks was observed in
18 (23.7%) with signs of IUGR (44.4%) of newborns.
Among women with the full-term pregnancy in all observations
reduction or a full rassasyvaniye of subchorial hematomas was
noted. At the same time complete recovery of a blood-groove was
at 49 (84.5%) the person, and partial at 9 (15.5%). In group of
women with prematurely born pregnancy at 12 (66.7%) the lack
of a rassasyvaniye of a hematoma and only at 6 (33.3%) its partial
reduction is noted. In one of these observations the subchorial
blood stream completely was not restored.
Thus, reduction of subchorial hematomas or their full
rassasyvaniye with the partial or completely restored blood-groove,
as a result of the carried-out treatment, is optimum predictive sign
on pregnancy incubation [1-3].
Tchaikovsky K, Syenko Ya, Mogilinsky M, Vros M, Shchepitsa R, et al.
(2007) Chaykovskaya Uterine плаценьтарный a blood stream in early
durations of gestation at the menacing abortion against the background
of use of the vaginal micronized progesterone or an oral didrogesteron.
Fertility and Sterility 87(3).