First-trimester intrauterine hematoma and outcome of pregnancy.
OBJECTIVE
To evaluate the outcome of pregnancies complicated by first-trimester intrauterine hematoma.


METHODS
An analysis was performed on 248 cases. The pregnancy outcome was correlated with hematoma volume, gestational age (weeks), and maternal age (years).


RESULTS
One hundred eighty-two cases were eligible for the study. Clinical complications occurred in 38.5% of the cases (adverse outcome group). Spontaneous abortion (14.3%), fetal growth restriction (7.7%), and preterm delivery (6.6%) were the most frequent clinical conditions observed. Considering the hematoma variables in adverse and favorable outcome groups, we found a significant difference only for gestational age at diagnosis. The median gestational age was significantly lower (P < .02) in the adverse outcome group (7.27, I and III quartiles 6.22-8.78) than in the favorable outcome cases (8.62, I and III quartiles 6.70-9.98). Among clinical conditions, the median gestational age was significantly lower (P = .02) in pregnancies complicated by spontaneous abortion (6.60, I and III quartiles 5.95-8.36) than in cases not ending in a miscarriage (8.50, I and III quartiles 6.70-9.91). The overall risk of adverse outcome was 2.4 times higher when the hematoma was diagnosed before 9 weeks (odds ratio 2.37, 95% confidence interval 1.20-4.70). In particular, intrauterine hematoma observed before 9 weeks significantly increases the risk of spontaneous abortion (odds ratio 14.79, 95% confidence interval 1.95-112.09)


CONCLUSIONS
Intrauterine hematoma can affect the outcome of pregnancy. The risk of spontaneous abortion is related to gestational age and is significantly increased if diagnosed before 9 weeks.


METHODS
III.
Maso
Gianpaolo
G
Department of Obstetrics and Gynecology, IRCCS Burlo Garofolo, University of Trieste, Via dell'Istria 65, I-34137 Trieste, Italy.
D'Ottavio
Giuseppina
G
De Seta
Francesco
F
Sartore
Andrea
A
Piccoli
Monica
M
Mandruzzato
Giampaolo
G
D000022:Abortion, Spontaneous / Q000453:epidemiology / Q000209:etiology; D000328:Adult; D000704:Analysis of Variance; D015331:Cohort Studies; D005260:Female; D005317:Fetal Growth Retardation / Q000453:epidemiology / Q000209:etiology; D005500:Follow-Up Studies; D006406:Hematoma / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D008423:Maternal Age; D007752:Obstetric Labor, Premature / Q000453:epidemiology / Q000209:etiology; D016017:Odds Ratio; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000175:diagnosis*; D011256:Pregnancy Outcome; D011261:Pregnancy Trimester, First; D011336:Probability; D012189:Retrospective Studies; D018570:Risk Assessment; D018709:Statistics, Nonparametric; D014592:Uterine Hemorrhage / Q000150:complications* / Q000175:diagnosis