Retrochorial hematoma during early pregnancy: treatment

2024 Author: Priscilla Miln | [email protected]. Last modified: 2023-12-16 00:21

For any woman, pregnancy is the main event that most of the fair sex strives for, starting from childhood. The joy of the upcoming event in a few months is simply impossible to describe. However, there are some issues that can overshadow it. One of them is a retrochorial hematoma.

Unfortunately, in our time it rarely happens that the bearing of a child proceeds completely without stressful situations. And as many knowledgeable people advise, it is better to immediately consult a doctor if there are alarming signs of any nature. Let it be mere trifles, but this is the only way to control the entire process and protect not only yourself, but also your child.

What is this pathology and what are the main causes of its occurrence?

General information

During pregnancy, a woman's body undergoes hormonal changes. But thisthat's not all - the main body is also undergoing changes, but, more importantly, it becomes vulnerable. This happens naturally: the uterus increases in size, its walls thicken. During the last metamorphoses, there is a risk of developing a hemorrhage, which in medical language is called a hematoma.

Such phenomena in the uterus appear not so rare and, as a rule, in the early stages of pregnancy. It is in the first trimester that the likelihood of detachment of the fetal egg increases. Retrochorial hematoma during pregnancy may result in its termination.

Therefore, it is extremely important for expectant mothers to listen to their body and seek medical help in a timely manner.

What is pathology?

Before figuring out why and where the hematoma of the uterus comes from, you should understand the very terminology of the disease. The fetus is surrounded by a villous embryonic membrane, which, connecting with the epithelium of the uterus, after a while forms the placenta. As a result, the vessels of the mother and fetus are intertwined. As a rule, it is fully formed after 16 weeks.

As noted above, pregnancy does not always go smoothly, and the fetal egg can exfoliate, which leads to rupture of the capillaries. As a result, an accumulation of blood forms between the wall of the uterus and the fetus, which is called a retrochorial hematoma, in scientific terms. Therefore, it mainly happens precisely in the early stages of pregnancy, when the placenta has not yet fully formed.

In medicalIn practice, there is also such a phenomenon as subamniotic hematoma, which occurs infrequently. It occurs as a result of self-resorption without any medical intervention. In this regard, such concepts should not be confused with each other.

Retrochorial pathology can also be in advanced form, which can be observed for more than 16 weeks. In this case, this suggests that the fetus begins to exfoliate directly from the placenta itself. At the same time, the risks and negative impact on the fetus increase significantly.

Causes of pathology

What can cause retrochorial hematoma during early pregnancy? As you know, any disease has its own cause of occurrence, this pathology is no exception. As statistics show, approximately 70% of expectant mothers develop retrochorial pathology. And since each woman has an individual body, the reason in each case may be different.

The exact causes have not yet been determined, however, there are several major factors contributing to the development of this hematoma. We single out 5 main reasons for this phenomenon, which will be discussed further.

Incorrect hormonal changes

Due to the high level of testosterone and prolactin, the metabolism between the mother and the fetus is difficult, as a result of which it passes with significant disturbances. The fetus eventually flakes off, often due to a lack of progesterone.

Woto avoid the development of retrochorial hematoma in the early stages of pregnancy, doctors prescribe synthetic drugs such as Duphaston or Utrozhestan. If the lack of progesterone has led to extensive fetal detachment, in this case, emergency hormonal therapy is prescribed, during which Duphaston is used in high doses at strictly defined intervals.

Exceeding the permissible norm of physical activity

Overfatigue can provoke an increased tone of the uterus, and the longer the gestation period, the higher the likelihood that the muscular apparatus will be in a tense state and may even harden.

Increased tone of the uterus is a condition of its muscles, which can be permanent or temporary. In the latter case, we are talking about contractions during childbirth. Constant layoffs can inevitably lead to undesirable consequences, up to the loss of a child.

For the treatment of retrochorial hematoma, droppers are given to pregnant women or necessary medications are prescribed.

STD exacerbation

In this case, an extensive inflammatory process may begin, and it affects not only the genital female organ itself, but also the organs located in the small pelvis. This leads to the formation of blood clots in the circulatory system of the fetus, as this is caused by the natural reaction of the female body: platelets are actively produced to suppress the infection.

How does this affectfetus? It stops receiving the necessary nutrients. It becomes difficult for the chorion to stay on the surface of the fetal egg, and its detachment occurs. All this leads to the threat of miscarriage.

Frequent exposure to vibrations

This risk exists in early pregnancy, around 8 weeks. Due to vibrations, the blood circulation of the fetus is disturbed. But waves over time lead to tissue separation.

In this regard, doctors try not to conduct ultrasound examinations too often during the first three to four months of pregnancy. This is especially undesirable with a clear threat of miscarriage.

Diseases

Retrochorial hematoma of the uterus during pregnancy can develop due to diseases that are associated with impaired blood clotting. And often this is such a pathological condition as thrombophilia. This genetic pathology is characterized by increased formation of blood clots.

And although in most cases the disease is mild and does not cause much discomfort in patients, it is very difficult for pregnant women to bear a child with such a diagnosis. There is always a risk of placental insufficiency, including placental abruption.

Other reasons

Other reasons include:

1. Having an alcohol, tobacco or drug addiction.
2. Abnormal development of the genitals.
3. Hypertension.
4. Prolonged stressful situations.
5. Infectious diseases of the genitourinary system.
6. Cases of severe toxicosis in the earlypregnancy.
7. Weak woman's immunity.
8. Overheating or hypothermia.

All of the above factors can cause the fetal egg to exfoliate from the chorion, and this leads to the formation of a retrochorial hematoma of the uterus.

But how can you identify this pathology yourself?

Symptomatics

Usually, retrochorial pathology during a woman's pregnancy does not manifest itself in any way. Diagnosis is complicated by the fact that the symptoms of a hematoma are easily confused with the course of any other pathological process. But there are some clear signs:

1. Pain in the lower abdomen is pulling in nature, the pain resembles the same on critical days.
2. Weakness persists even after proper rest.
3. There is a pulling pain in the lumbar region.
4. Uncharacteristic vaginal discharge.

And the last sign is worth more attention, as danger may lurk here. The color of the discharge can be light brown or deep red.

When a retrochorial hematoma is established and dark red discharge, one can talk about the gradual release of blood clots. If they are bright red in color, and even accompanied by pain, then you need to seek medical help. This indicates the formation of a hematoma or even an increase in its size.

As a rule, a hematoma is small, but in general it is a bruise,which can dissolve on its own without outside intervention. Only the process can take several weeks.

In the case of an enlarged hematoma, this negatively affects the development of the fetus, and the risks of spontaneous abortion also increase significantly.

Disease diagnosis

To make an accurate diagnosis and confirm or deny the presence of a hematoma, a pregnant woman will have to undergo a number of important studies. Most often, ultrasound is used, since such a diagnosis of retrochorial hematoma is reliable.

The complete clinical picture can be compiled on the basis of additional procedures performed:

• donating urine and blood;
• gynecological smear;
• conducting a coagulogram;
• biochemical blood test;
• STD test;
• study of the hormonal background of the female body.

All this together allows not only to identify the hematoma itself, but also to determine its type, size, structure, location in relation to the fetal egg. You can also find out the tone of the uterus.

Based on the data obtained, the specialist establishes the accuracy of the diagnosis and determines the overall picture of the further development of pregnancy, prescribes the necessary treatment.

Features of treatment

Depending on the nature of the course of the pathology, its treatment can take place in a hospital or on an outpatient basis, but under the close supervision of a specialist. If there is a suspicion of a hematoma, the woman is contraindicatedheavy workloads and stressful situations. It is necessary to keep calm, lie down with your legs slightly raised, which allows you to normalize the blood flow of the uterus.

Besides lifting weights, you should abstain from sexual activity. In addition, it is necessary to periodically donate blood to determine its coagulability. Usually, the treatment of retrochorial hematoma during pregnancy is carried out in a complex manner with the inclusion of a number of activities:

1. Taking medication to stop bleeding.
2. Elimination of increased uterine tone.
3. Restoration of the hormonal background of a woman.

You also need to follow a daily routine and eat right.

Since most medications are contraindicated for pregnant women (especially at the initial stage), experts select those drugs that have no effect on either the expectant mother or the fetus.

For the treatment of hematoma, vitamins are prescribed that strengthen the walls of blood vessels and stop bleeding ("Ascorutin", "Vikasol" and "Dicinon"). "No-shpa" and "Papaverine" are considered good drugs for relieving hypertonicity.

Result

Don't be afraid of such a seemingly terrible diagnosis and in no case should you panic. The main thing is to seek medical help in a timely manner. It is good when the hematoma is small and, possibly, serious intervention by a specialist is not required. But a severe form of retrochorial hematoma can be treated, onlyyou must follow all the recommendations of your doctor.