Obstetric and perinatal aspects of retrochorial hematomas

Abstract

The problem of pregnancy loss has medico-social, scientific and practical significance. Almost 85% of pregnancy loss occur in the I trimester of gestation (up to 13 weeks), and 15% – II and III trimesters. One of the causes of bleeding in the I trimester of gestation is retrochorial hematoma (RCH) – the accumulation of blood in the retrochorial space due to partial detachment of the chorionic plate from the adjacent of decidua in a genetically normal embryo. The article provides an analysis of scientific publications that highlight the obstetric and perinatal aspects of the characteristics of RCH, the etiological features of their occurrence and important points of the treatment to avoid the development of further complications, the preservation and prolongation of pregnancy. The features of diagnostics and subsequent therapy to provide early support for pregnancy and reduce the incidence of gestational complications are considered. Ultrasound examination of the uterus is of the great prognostic importance in the diagnosis of RCH, which can identify the threatening signs of pregnancy associated with preterm birth, development of fetal growth retardation, placental abruption in the ІІ and ІІІ trimesters, low fetal birth weight. The data of modern researches indicate that the diagnosis of RCH in the presence of a living genetically normal embryo, the appointment of pathogenetic therapy based on gestagenic and antifibrinolytic therapy is the key for the success of treatment of this perinatal pathology, a significantly decreasing the rate of pregnancy losses and an improvement in the quality of gestational process. Today, obstetricians and gynecologists have a deal with the task to find new preclinical signs to predict possible complications of pregnancy and develop effective algorithms for prevention and treatment, which will prolong pregnancy with RCH and achieve positive perinatal outcomes.