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