Clinical, laboratory, and ultrasonic evaluation and pregnancy management tactics in different forms of chorionic pathology in the first trimester

The clinical, ultrasonic, bacteriological, virological, hormonal, immunological, molecular biological, and hemostasiological parameters were retrospectively analyzed in 30 pregnant women with chorionic maldevelopment as subchoreal (n = 20) and subamniotic (n = 10) hematomas (a study group). A control group comprised 38 healthy primagravidas. Subchoreal hematomas have been ascertained to be more common than subamniotic ones. They are diagnosed at an average of 8.3±0.4 weeks gestation; their mean volume is 1.32±0.25 cm3. In subamniotic hematomas, these are l2.1±0.5 weeks and 17.7±6.0 cm3, respectively. Subchoreal hematomas generally develop in the presence of thrombophilic states, immunological disorders, and HLA Class II compatibility in a married couple. Subamniotic hematomas more frequently occur in the presence of chronic bacterial and viral infections. Subchoreal hepatomas accompany chorionic hypoplasia and they are attended by uterine hemodynamic disorders. In addition to the conventional therapy, it is necessary to use hemostatic therapy in combination with microcirculation-improving agents in this type of hematomas and hemostatic agents, antibacterial and immunomodulating therapies in subamniotic hematomas.

the first trimester of pregnancy, habitual pregnancy loss, subamniotic hematoma, subchoreal hematoma