CLINICAL VALUE OF RETROCHORIAL HEMATOMA IN PREGNANT WOMEN HAVING RISK FACTORS FOR REPRODUCTIVE LOSSES: MANAGEMENT EXPERIENCE IN AN ANTENATAL CLINIC

Objective. To evaluate the impact of first-trimester retrochorial hematoma on the course of pregnancy and to develop an individual management for women with this pathology in an antenatal clinic. Subjects and methods. The study covered 99 pregnant women having a history or risk factors of fetal depletion syndrome (FDS). The questioning of pregnant women allowed consideration of clinicoanamnestic data, past personal and family histories, and delivery outcomes. Laboratory examination comprised determination of the molecular genetic markers of thrombophilias and functional evaluation of the hemostatic system. Results. Pregnancy was complicated by early threatened miscarriage and retrochorial hematoma in 32 (32.3%) of the 99 pregnant women having a history or risk factors of FDS. Retrochorial hematoma was a ground for examining patients for the carriage of polymorphism of genes associated with hereditary thrombophilia and for assigning these pregnant women to a group at risk for obstetric and perinatal complications. Conclusion. The results of the clinical observation suggest that early threatened miscarriage with retrochorial hematoma may be a marker of hereditary thrombophilias and a predictor for late obstetric complications. In case of retrochorial hematoma, combination therapy is a necessary condition for the prevention of FDS. The use of dydrogesterone (Duphaston) in combination with low molecular-weight heparins, antibacterial therapy, and systemic enzyme therapy reduces the risk of late obstetric complications and FDS.

fetal depletion syndrome, retrochorial hematoma, hereditary thrombophilia, dydrogesterone, low molecular-weight heparins