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Perigestational Hemorrhage
Roya Sohaey, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Abbreviations

                • Perigestational hemorrhage (PGH)
              • Synonyms

                • Subchorionic hematoma
              • Definitions

                • Hematoma in subchorionic space adjacent to gestational sac (GS)
                • Bleeding from chorionic frondosum (CF) later in 1st trimester

              IMAGING

              • General Features

                • Ultrasonographic Findings

                  • Imaging Recommendations

                    DIFFERENTIAL DIAGNOSIS

                      PATHOLOGY

                      • General Features

                        • Staging, Grading, & Classification

                          CLINICAL ISSUES

                          • Presentation

                            • Demographics

                              • Natural History & Prognosis

                                • Treatment

                                  DIAGNOSTIC CHECKLIST

                                  • Consider

                                    • Image Interpretation Pearls

                                      Selected References

                                      1. Asato K et al: Subchorionic hematoma occurs more frequently in in vitro fertilization pregnancy. Eur J Obstet Gynecol Reprod Biol. 181:41-4, 2014
                                      2. Ozkaya E et al: Significance of subchorionic haemorrhage and pregnancy outcome in threatened miscarriage to predict miscarriage, pre-term labour and intrauterine growth restriction. J Obstet Gynaecol. 31(3):210-2, 2011
                                      3. Tuuli MG et al: Perinatal outcomes in women with subchorionic hematoma: a systematic review and meta-analysis. Obstet Gynecol. 117(5):1205-12, 2011
                                      4. Kumbak B et al: Elevated maternal serum alpha-fetoprotein levels in patients with subchorionic hematoma. J Matern Fetal Neonatal Med. 23(7):717-9, 2010
                                      5. Norman SM et al: Ultrasound-detected subchorionic hemorrhage and the obstetric implications. Obstet Gynecol. 116(2 Pt 1):311-5, 2010
                                      6. Dighe M et al: Sonography in first trimester bleeding. J Clin Ultrasound. 36(6):352-66, 2008
                                      7. Pelinescu-Onciul D: Subchorionic hemorrhage treatment with dydrogesterone. Gynecol Endocrinol. 23 Suppl 1:77-81, 2007
                                      8. Dogra V et al: First trimester bleeding evaluation. Ultrasound Q. 21(2):69-85; quiz 149-50, 153-4, 2005
                                      9. Nishijima K et al: Massive subchorionic hematoma: peculiar prenatal images and review of the literature. Fetal Diagn Ther. 20(1):23-6, 2005
                                      10. Falco P et al: Sonography of pregnancies with first-trimester bleeding and a small intrauterine gestational sac without a demonstrable embryo. Ultrasound Obstet Gynecol. 21(1):62-5, 2003
                                      11. Nagy S et al: Clinical significance of subchorionic and retroplacental hematomas detected in the first trimester of pregnancy. Obstet Gynecol. 102(1):94-100, 2003
                                      12. Sharma G et al: Prognostic factors associated with antenatal subchorionic echolucencies. Am J Obstet Gynecol. 189(4):994-6, 2003
                                      13. Bennett GL et al: Subchorionic hemorrhage in first-trimester pregnancies: prediction of pregnancy outcome with sonography. Radiology. 200(3):803-6, 1996
                                      14. Dickey RP et al: Relationship of first-trimester subchorionic bleeding detected by color Doppler ultrasound to subchorionic fluid, clinical bleeding, and pregnancy outcome. Obstet Gynecol. 80(3 Pt 1):415-20, 1992
                                      Related Anatomy
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                                      Related Differential Diagnoses
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                                      References
                                      Tables

                                      Tables

                                      KEY FACTS

                                      • Terminology

                                        • Imaging

                                          • Top Differential Diagnoses

                                            • Pathology

                                              • Clinical Issues

                                                • Diagnostic Checklist

                                                  TERMINOLOGY

                                                  • Abbreviations

                                                    • Perigestational hemorrhage (PGH)
                                                  • Synonyms

                                                    • Subchorionic hematoma
                                                  • Definitions

                                                    • Hematoma in subchorionic space adjacent to gestational sac (GS)
                                                    • Bleeding from chorionic frondosum (CF) later in 1st trimester

                                                  IMAGING

                                                  • General Features

                                                    • Ultrasonographic Findings

                                                      • Imaging Recommendations

                                                        DIFFERENTIAL DIAGNOSIS

                                                          PATHOLOGY

                                                          • General Features

                                                            • Staging, Grading, & Classification

                                                              CLINICAL ISSUES

                                                              • Presentation

                                                                • Demographics

                                                                  • Natural History & Prognosis

                                                                    • Treatment

                                                                      DIAGNOSTIC CHECKLIST

                                                                      • Consider

                                                                        • Image Interpretation Pearls

                                                                          Selected References

                                                                          1. Asato K et al: Subchorionic hematoma occurs more frequently in in vitro fertilization pregnancy. Eur J Obstet Gynecol Reprod Biol. 181:41-4, 2014
                                                                          2. Ozkaya E et al: Significance of subchorionic haemorrhage and pregnancy outcome in threatened miscarriage to predict miscarriage, pre-term labour and intrauterine growth restriction. J Obstet Gynaecol. 31(3):210-2, 2011
                                                                          3. Tuuli MG et al: Perinatal outcomes in women with subchorionic hematoma: a systematic review and meta-analysis. Obstet Gynecol. 117(5):1205-12, 2011
                                                                          4. Kumbak B et al: Elevated maternal serum alpha-fetoprotein levels in patients with subchorionic hematoma. J Matern Fetal Neonatal Med. 23(7):717-9, 2010
                                                                          5. Norman SM et al: Ultrasound-detected subchorionic hemorrhage and the obstetric implications. Obstet Gynecol. 116(2 Pt 1):311-5, 2010
                                                                          6. Dighe M et al: Sonography in first trimester bleeding. J Clin Ultrasound. 36(6):352-66, 2008
                                                                          7. Pelinescu-Onciul D: Subchorionic hemorrhage treatment with dydrogesterone. Gynecol Endocrinol. 23 Suppl 1:77-81, 2007
                                                                          8. Dogra V et al: First trimester bleeding evaluation. Ultrasound Q. 21(2):69-85; quiz 149-50, 153-4, 2005
                                                                          9. Nishijima K et al: Massive subchorionic hematoma: peculiar prenatal images and review of the literature. Fetal Diagn Ther. 20(1):23-6, 2005
                                                                          10. Falco P et al: Sonography of pregnancies with first-trimester bleeding and a small intrauterine gestational sac without a demonstrable embryo. Ultrasound Obstet Gynecol. 21(1):62-5, 2003
                                                                          11. Nagy S et al: Clinical significance of subchorionic and retroplacental hematomas detected in the first trimester of pregnancy. Obstet Gynecol. 102(1):94-100, 2003
                                                                          12. Sharma G et al: Prognostic factors associated with antenatal subchorionic echolucencies. Am J Obstet Gynecol. 189(4):994-6, 2003
                                                                          13. Bennett GL et al: Subchorionic hemorrhage in first-trimester pregnancies: prediction of pregnancy outcome with sonography. Radiology. 200(3):803-6, 1996
                                                                          14. Dickey RP et al: Relationship of first-trimester subchorionic bleeding detected by color Doppler ultrasound to subchorionic fluid, clinical bleeding, and pregnancy outcome. Obstet Gynecol. 80(3 Pt 1):415-20, 1992