Document Detail


Ultrasound-detected subchorionic hemorrhage and the obstetric implications.
MedLine Citation:
PMID:  20664390     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To estimate the association between the ultrasonographic diagnosis of subchorionic hemorrhage and adverse pregnancy outcomes. METHODS: This was a retrospective cohort study of all consecutive women undergoing routine ultrasonography before 22 weeks with a singleton gestation at one institution from 1994 to 2008. Presence or absence of subchorionic hemorrhage defined the two study groups. The primary outcomes were abruption, intrauterine growth restriction defined as birth weight less than the 10th percentile, and nonanomalous intrauterine fetal demise after 20 weeks. Secondary outcomes included preeclampsia, preterm premature rupture of membranes, and preterm delivery before 37 weeks and before 34 weeks of gestation. Univariable, bivariate, and multiple logistic regression analyses were performed. RESULTS: Of the 63,966 women in the patient population, 1,081 had subchorionic hemorrhage (1.7%). Women with a subchorionic hemorrhage were at increased risk of abruption (n=432, 3.6% compared with 0.6%, adjusted odds ratio 2.6, 95% confidence interval 1.8-3.7) and of preterm delivery (n=6,601, 15.5% compared with 10.5%, adjusted odds ratio 1.3, 95% confidence interval 1.1-1.5), even after adjusting for bleeding during pregnancy, chronic hypertension, body mass index, race, diabetes mellitus, tobacco use, and previous preterm delivery. CONCLUSION: Women with ultrasound-detected subchorionic hemorrhage before 22 weeks of gestation are at increased risk of placental abruption and preterm delivery but are not at increased risk of other adverse pregnancy outcomes. LEVEL OF EVIDENCE: II.
Authors:
Shayna M Norman; Anthony O Odibo; George A Macones; Jeffrey M Dicke; James P Crane; Alison G Cahill
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  116     ISSN:  1873-233X     ISO Abbreviation:  Obstet Gynecol     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-28     Completed Date:  2010-08-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  311-5     Citation Subset:  AIM; IM    
Affiliation:
Department of Obstetrics and Gynecology, Washington University, St Louis, Missouri, USA. normans@wudosis.wustl.edu
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MeSH Terms
Descriptor/Qualifier:
Abruptio Placentae / etiology
Adult
Chorion / ultrasonography*
Cohort Studies
Female
Hemorrhage / complications,  ultrasonography*
Humans
Placenta Diseases / ultrasonography*
Pregnancy
Pregnancy Outcome
Premature Birth / etiology
Retrospective Studies
Risk Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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