Massive pre-placental and subchorionic haematoma.
We report an unusual case of massive pre-placental and subchorionic haematoma occurring in a 26-year-old woman who presented with antepartum haemorrhage at 24 weeks gestation. Ultrasonography showed a subchorionic haematoma in the lower posterior uterine wall measuring 5.0 cm in largest diameter. There was also a separate irregular multiloculated structure measuring 4.3 cm in largest diameter on the surface of the placenta, due to a pre-placental haematoma. The subchorionic haematoma diminished in size over time, while the pre-placental haematoma continued to grow, measuring 9.0 cm at 28 weeks, and 9.3 cm at 32 weeks. At 32 weeks, the patient presented with premature rupture of membranes and four days later, an emergency caesarean section was performed when the patient had another episode of severe antepartum haemorrhage. Both mother and child recovered well. The current literature on such haematomas is reviewed.
Loi
K
K
Division of Obstetrics and Gynaecology, KK Women's and Children's Hospital, Singapore. kelly_loi@hotmail.com
Tan
K T
KT
D000077713:17 alpha-Hydroxyprogesterone Caproate; D000328:Adult; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000097:blood / Q000209:etiology*; D006406:Hematoma / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D006908:Hydroxyprogesterones / Q000627:therapeutic use; D009543:Nifedipine / Q000627:therapeutic use; D010922:Placenta Diseases / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011372:Progestins / Q000627:therapeutic use; D013927:Thrombosis / Q000188:drug therapy / Q000503:physiopathology*; D015149:Tocolytic Agents / Q000627:therapeutic use; D014463:Ultrasonography; D014592:Uterine Hemorrhage / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology*
D006908:Hydroxyprogesterones; D011372:Progestins; D015149:Tocolytic Agents; D000077713:17 alpha-Hydroxyprogesterone Caproate; D009543:Nifedipine