Diagnosis and treatment of hematoma in the uterus during pregnancy

For many expectant mothers, uterine hematomas during pregnancy can be concerning. Although the formation of these blood clots between the uterine wall and the gestational sac may seem concerning, they are frequently treatable with the right diagnosis and care.

It’s critical to realize that not all hematomas present a significant risk to the unborn child. It can frequently be found during a standard ultrasound, and a medical professional can closely monitor it. There may be some symptoms, such as light bleeding or cramps, but sometimes none at all.

The location, size, and stage of pregnancy all affect the course of treatment. To aid in the body’s hematoma absorption, rest, minimal physical exertion, and close observation are recommended. Your physician might suggest taking extra precautions to guarantee your and your child’s safety.

Pregnant women may find it concerning when blood builds up between the uterine wall and the placenta, a condition known as a hematoma in the uterus. Using ultrasound to diagnose this condition early is essential to its management. Depending on the size and location of the hematoma, the course of treatment may change, but in order to lower the risk of complications, rest, close observation, and occasionally medication are standard. To protect the health and wellbeing of mother and child, it’s critical for expectant mothers to maintain regular communication with their healthcare provider.

What is it?

Hematomas can form in the uterus during pregnancy for a variety of very distinct reasons. Hemostases are classified by medical professionals as pathological conditions caused by blood clots in enclosed areas. The location of the blood accumulation determines the hematoma’s clinical form. Physicians differentiate between various forms of this illness. Each of them is unique and influences the prognosis of pregnancy development in a different way. Certain hematoma types that are localized in specific areas of the uterus can result in dangerous complications for both the pregnant woman and her unborn child.

It should be mentioned that uterine hematomas can manifest at various phases of gestation. Certain diseases are exclusive to the first trimester, while others manifest in the latter half of the pregnancy.

The ensuing disorders vary in severity. Occasionally, the symptoms can deteriorate the expectant mother’s overall health to the point where it becomes very challenging for her to carry the baby to term.

Options

When determining the diagnosis and clinical type of pathology, doctors use a variety of terms. Such specific medical terminology can confuse anyone. A complex and long name of the diagnosis can completely confuse the expectant mother. It is worth understanding what are the most common hematomas that occur in the uterus during pregnancy. Subchorial hematoma is one of the pathology options. In this case, blood accumulates between the chorionic membrane covering the embryo and the uterine wall. Unfortunately, such a pathology is often encountered in obstetric practice. The risk of developing a spontaneous abortion in this case is quite high. In medicine, it happens that several terms can often be used to denote the same process. Many specialists also call subchorial hematoma retrochorial or retrothecal. Doctors have learned to diagnose such a pathology quite well. Retrothecal hematoma is currently determined using ultrasound examination.

Blood can accumulate in various places of the uterus. It can spread between the chorionic membranes, and also completely flow behind them. In this case, interthecal and subthecal hematomas develop. Accumulation of blood directly behind the chorionic membranes can also be called a retrothecal hematoma. Pathologies associated with the chorion usually develop in the earliest stages of pregnancy. It is at this time that the chorion is very important for the intrauterine development of the fetus. Then it gradually transforms into the placenta, which already “takes on” the provision of a number of functions necessary for the full growth of the baby in the mother"s womb. Another unique organ that appears in the female body only during pregnancy is the amnion. This is the water membrane in which the baby is located. It provides a special water environment, without which the intrauterine development of the child is impossible.

Blood accumulation in the amniotic shell region can result from hemorrhages that happen for a variety of reasons. In this instance, the uterus has hematomas in various places. They could be retro-amniotic or subamniotic.

Pathologies associated with germinal membranes develop in the first half of pregnancy. Gradually, the placenta begins to form from the embryonic membranes. This feature explains the differences in the names of different hematomas. When blood is accumulated behind placental tissues, a retro -placental hematoma appears. This condition can be extremely dangerous and even lead to the development of fetoplacental insufficiency. With this pathology, oxygen and nutrients are not admitted to the children"s body. Long -term fetoplacental deficiency can even lead to the formation of various defects and anomalies of development in the baby. Blood accumulation in the uterus can lead to the fact that a pregnant woman develops adverse symptoms. Bloody and dark brown discharge from the genital tract comes from emptying the hematoma. The accumulated blood can flow out, which leads to the appearance of specific discharge from the genital tract. This symptom can really scare the expectant mother.

It is imperative that the expectant mother seek medical attention in such a situation. It is only a medical professional who can ascertain the precise cause of the expectant mother’s uterine bleeding.

How is the diagnosis made?

Nowadays, doctors can quickly and accurately diagnose a potentially dangerous uterine hematoma thanks to the development of ultrasound exams. The resolution of modern devices is fairly high. Even tiny blood accumulations can be identified with their assistance. Even complex pathologies that were previously impossible to detect in a timely manner can now be identified by doctors with the aid of ultrasound. Ultrasound is the primary method used to diagnose different types of hematomas localized in the uterus.

The main method

Reviews of many women who have already become mothers, but were faced with the appearance of a hematoma in the uterus during pregnancy, indicate that the diagnosis was established after an ultrasound. In most cases, a hematoma in the uterus is detected during routine or screening examinations. It often happens that with this pathology, a woman does not develop any uncomfortable symptoms. In such cases, a hematoma is detected only during screening. Quite often, a retroamniotic hematoma is diagnosed at 11-13 weeks of pregnancy. Modern ultrasound machines not only help to accurately determine the location and size of the hematoma, but also detect the development of dangerous complications. An ultrasound specialist can quite easily determine the onset of placental abruption – a dangerous pathology that can contribute to premature birth or even intrauterine death of the fetus.

During the analysis, an ultrasound specialist determines the location of the ovum, as well as any of its deformations. He also evaluates the thickness of the uterine walls. Thickening of the uterine wall can be a sign of the presence of a hematoma in it. When conducting the examination, the doctor necessarily evaluates not only the general development of the fetus and the condition of the woman"s reproductive organs. He studies the structure of the placental membranes or placenta. Such detailed diagnostics allows the ultrasound doctor to identify all defects and damage, as well as blood accumulations between the membranes. Many doctors believe that the prognosis for the course of pregnancy depends on the size of the hematoma. It can have a wide variety of sizes. The prognosis for a hematoma of 14 mm is usually better than for a hematoma of 60-70 mm. The development of pregnancy largely depends on the localization of the hematoma in the uterine cavity, as well as on the condition of the pregnant woman"s body.

A positive outcome is likely in this case if the expectant mother does not have any concurrent chronic diseases and her pregnancy was progressing normally prior to the hematoma’s appearance.

Auxiliary examinations

An important study that helps to assess the severity of functional disorders that have arisen with a hematoma in the uterus is Dopplerography. This diagnostic method allows you to evaluate the blood flow in the blood vessels that feed the fetus. Very often, with a hematoma localized in the uterus, intrauterine hypoxia develops – a condition in which the child"s body does not receive enough oxygen. This pathological condition contributes to the fact that the formation of the child"s internal organs can slow down. In such a situation, the risk of developing dangerous anomalies is quite high. Using Dopplerography, doctors can quite easily evaluate the indicators of uteroplacental blood flow, and also, if necessary, correct them (by prescribing drug therapy). Dopplerographic studies of women with a hematoma in the uterus can be carried out several times during pregnancy. This is necessary so that doctors can assess the dynamics of the development of the pathology, and, if necessary, adjust the chosen tactics for managing pregnancy. Dopplerography is an absolutely painless method. The expectant mother does not need to undergo any special preparation. The doctor must record all the obtained blood flow parameters in his report, which is pasted into the pregnant woman"s medical record.

A multitude of complications may arise in conjunction with a uterine hematoma. Doctors have to prescribe certain tests so they don’t miss them. Easy laboratory tests also enable you to determine the appropriate treatment plan by gauging the severity of the arising disorders.

• general clinical studies (general blood and urine tests);
• biochemical test to determine blood clotting;
• taking material from the vagina and genital tract (smear) for bacteriological testing;
• determining hormone levels.

The tests on the list may vary depending on each unique situation. An individual obstetrician-gynecologist chooses the examination plan.

The expectant mother may be referred by the physician to other physicians if more consultations are required. The expectant mother is referred to a hematologist for consultation if the uterine hematoma becomes more complicated due to the emergence of blood coagulation system disorders. This specialist will choose the appropriate course of treatment to address the developed functional disorders after performing a more thorough diagnosis of the resulting pathological condition.

While uterine hematomas during pregnancy can be worrisome, prompt diagnosis and appropriate treatment can help to ensure the best possible outcome for the mother and unborn child. It’s critical to recognize the symptoms, which may include cramps or spotting, and to get medical help if something feels off.

Thankfully, with rest and close observation, many cases of uterine hematomas resolve on their own. Depending on the severity of the ailment, doctors may also suggest particular courses of action. Taking your doctor’s advice and going to checkups on a regular basis can help you manage the situation.

Every pregnancy is different, and although a uterine hematoma can be concerning, most women who receive the appropriate support and timely intervention go on to have healthy pregnancies. Never be afraid to ask your healthcare provider for advice if you have any concerns.

Video on the topic

Retrochorial hematoma, checklist of what to do? Tests, examinations, treatment.

Lecture "Hematomas in early pregnancy: diagnosis and prognosis"

Retrochorial hematoma during pregnancy, discharge, hematoma in the uterus, size, treatment and causes