Antenatal sonographic diagnosis of massive subchorionic hematoma: a case report.
BACKGROUND
Massive subchorionic hematoma (MSH), described by Breus in 1892 (Breus mole), is a rare but serious condition in pregnancy in which a large amount of blood, mainly maternal, collects and dissects the chorionic plate from the villous chorion.


METHODS
A case of MSH was complicated by intrauterine growth retardation (IUGR) and intrauterine fetal death at 23 weeks' gestation. Pregnancy was complicated by advanced maternal age and chronic hypertension. There was no antenatal vaginal bleeding. Ultrasound at 19 weeks showed a small-for-gestational-age fetus, echogenic bowel and globular placenta. Amniocentesis revealed a normal male karyotype. At 23 weeks the patient presented with vaginal spotting, cramping and absent fetal heart tones. Labor was induced with misoprostol, and vaginal delivery occurred. The placenta showed an organized thrombus adherent to the chorionic plate, and a large subchorionic hematoma comprised at least half the disc volume.


CONCLUSIONS
Antenatal sonographic diagnosis of MSH and IUGR can be achieved.
Fisteag-Kiprono
Luissa
L
Department of Obstetrics and Gynecology, Wright State University School of Medicine, Dayton, Ohio 45409, USA.
Foster
Kimberly
K
McKenna
David
D
Baptista
Matt
M
D000328:Adult; D002824:Chorionic Villi / Q000000981:diagnostic imaging / Q000473:pathology; D005260:Female; D005313:Fetal Death; D005317:Fetal Growth Retardation; D006406:Hematoma / Q000000981:diagnostic imaging*; D006801:Humans; D006973:Hypertension / Q000150:complications; D010920:Placenta / Q000098:blood supply* / Q000473:pathology*; D011247:Pregnancy; D011248:Pregnancy Complications; D013927:Thrombosis / Q000209:etiology*; D016216:Ultrasonography, Prenatal