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360: Ultrasound detected subchorionic hemorrhage: what are the implications?

      Objective

      To estimate the association between the sonographic diagnosis of subchorionic hemorrhage (SCH) and adverse pregnancy outcomes.

      Study Design

      This was a retrospective cohort study of all consecutive women undergoing routine ultrasound prior to 22 weeks with a singleton gestation at two institutions from 1990-2007. Presence or absence of SCH defined the two study groups. The primary outcomes were abruption, intrauterine growth restriction (IUGR) defined as birth weight < 10th %ile, non-anomalous intrauterine fetal demise (IUFD) after 20 weeks, pre-eclampsia (PEC), preterm premature rupture of membranes (PPROM), and preterm delivery (PTD) <37 weeks and <34 weeks. Univariate, bivariate, and logistic regression analyses were performed.

      Results

      Of the 63, 966 women in the patient population, 1081 had SCH (1.7%). Women with SCH were at increased risk for developing abruption and for PTD, even after adjusting for bleeding during pregnancy, chronic hypertension, tobacco use, and prior PTD.
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      Conclusion

      Women with ultrasound detected SCH prior to 22 weeks are at increased risk for abruption, preterm delivery, and a trend towards PPROM, but are not at increased risk for other adverse pregnancy outcomes. These findings may identify patients at risk for PTD.