Pathogenesis of chorionic detachment and intrauterine hematomas in early pregnancy: a literature review

Abstract

Aim: to systematize scientific data on the frequency and pathogenesis of retrochorial and retroroamniotic hematomas in early pregnancy, including the recently published data.Materials and methods. We used sources from the electronic databases PubMed, Embase, eLibrary and articles in peerreviewed open access journals. The search was conducted using the keywords in Russian and English: retrochorial hematoma, retrochorial hemorrhage, subamniotic hematoma, pregnancy outcomes in subamniotic haematoma, pregnancy outcomes in subchorial haematoma, angiogenesis, embryogenesis, placentogenesis. The analysis included sources from the recent 30 years. We excluded publications on multiple pregnancies, ectopic pregnancy, and other sources that did not focus on the pathogenesis of chorionic detachment.Results. The following factors play a role in the occurrence of chorionic detachment: intrauterine malformations, bacterial/viral infection, chronic endometritis, immunological factors, maternal coagulation disorders (hemorrhagic diathesis, genetic thrombophilia, antiphospholipid syndrome, chronic forms of DIC), severe arterial hypertension, and habitual miscarriages.Conclusion. Knowledge of the pathogenetic mechanisms of chorionic detachment is necessary for a differential diagnosis and subsequent successful preservation of pregnancy.