The significance of ultrasound features of sub-chorionic haemorrhage as a predictor of adverse perinatal outcome: A retrospective review

Journal article


Rebecca White and Heather Kilgour Venables 2023. The significance of ultrasound features of sub-chorionic haemorrhage as a predictor of adverse perinatal outcome: A retrospective review. European Journal of Obstetrics & Gynecology and Reproductive Biology. 289, pp. 23-28. https://doi.org/10.1016/j.ejogrb.2023.08.009
AuthorsRebecca White and Heather Kilgour Venables
Abstract

Introduction
This retrospective single centre study considers the predictive value of specific ultrasound features of sub-chorionic haemorrhage (SCH) as potential indicators of adverse pregnancy outcome.

Methods
Ultrasound reports and images were reviewed for 160 participants presenting to an early pregnancy assessment unit from January 2018 to January 2019. Participants were selected based upon the presence of SCH within the first trimester. The outcome of each pregnancy and the features of SCH, including the size, location and echogenicity were recorded and multinominal logistic regression was used to establish predictive value.

Results
The majority of participants were asymptomatic and delivered healthy babies. 24% miscarried prior to delivery or had stillborn babies; the features of bleed within this group revealed an increased prevalence of adverse outcome in the presence of moderate sized haemorrhage (p = 0.02). 61% of miscarried pregnancies presented with “wrapping” SCH, in which haemorrhage encased the gestation sac, suggesting wrapping posed a probable risk (p = 0.01). 71% of miscarriages occurred within 5 + 0–10 + 0 weeks gestation. Persistent SCH was of greater incidence within those participants with adverse outcome (57%). There was no association between fetal abnormality and miscarriage. Jaundice babies and premature delivery occurred more frequently (p = 0.001) and may be a secondary finding following SCH.

Conclusion
There was a strong correlation between presence of SCH in early pregnancy and rate of miscarriage. Specific ultrasound features of SCH, most notably a wrapping location with moderate size, may be indicative of increased risk of miscarriage or post-natal complications. Jaundice and premature births may have an association with placental compromise.

KeywordsMiscarriage ; Fetal demise; Early pregnancy
Year2023
JournalEuropean Journal of Obstetrics & Gynecology and Reproductive Biology
Journal citation289, pp. 23-28
PublisherElsevier
ISSN1872-7654
Digital Object Identifier (DOI)https://doi.org/10.1016/j.ejogrb.2023.08.009
Web address (URL)https://doi.org/10.1016/j.ejogrb.2023.08.009
https://www.sciencedirect.com/science/article/pii/S0301211523003159
Output statusPublished
Publication dates22 Aug 2023
Publication process dates
Deposited24 Aug 2023
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https://repository.derby.ac.uk/item/q03xw/the-significance-of-ultrasound-features-of-sub-chorionic-haemorrhage-as-a-predictor-of-adverse-perinatal-outcome-a-retrospective-review

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