title: Subchorionic hematoma associated with thrombophilia: report of three cases.
abstract: Subchorionic hematomas (SCHs) are associated with poor reproductive outcome including spontaneous abortions and stillbirth. Although many associations with maternal and prenatal factors have been reported, an underlying etiology has not been elucidated. We report three cases of SCHs associated with thrombophilias in the mother. One patient suffered a fetal demise at 30 wk gestational age, and two patients had second trimester losses. The mother of the 30-wk fetus was homozygous for mutations on the methylene-tetrahydrofolate reductase gene C677T. The other two patients had Protein S deficiency. SCHs may be associated with abnormal coagulative states suggesting that the underlying etiology of SCH may be related to hypercoagulability in the maternal circulation. The presence of a SCH may be the first indicator of an underlying thrombophilia and, thus, it is suggested that women who have placentas showing SCH should undergo a thrombophilia workup.
authors.affiliation: Department of Pathology UH/E158, University of Medicine and Dentistry of New Jersey-New Jersey Medical School, 185 South Orange Avenue, Newark, NJ 07103, USA. hellerds@umdnj.edu
authors.forename: Debra S
authors.initials: DS
authors.lastname: Heller
authors.forename: Demaretta
authors.initials: D
authors.lastname: Rush
authors.forename: Rebecca N
authors.initials: RN
authors.lastname: Baergen
mesh_terms: D000328:Adult; D002823:Chorion / Q000473:pathology*; D005260:Female; D006406:Hematoma / Q000209:etiology / Q000473:pathology*; D006720:Homozygote; D006801:Humans; D042965:Methylenetetrahydrofolate Reductase (NADPH2) / Q000235:genetics; D009154:Mutation; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic; D011256:Pregnancy Outcome; D018455:Protein S Deficiency / Q000150:complications; D019851:Thrombophilia / Q000150:complications / Q000473:pathology
chemical_list: D042965:Methylenetetrahydrofolate Reductase (NADPH2)