Comparative Analysis Of Pregnancy Outcome And Influencing Factors Of Retroplacental Hematoma And Subchorionic Hematoma

OBJECTIVE:to improve the understanding of two kinds of hematoma by contrastive analysis of pregnancy outcome and influencing factors of retroplacental hematoma and subchorionic hematoma.METHODS:to collect 2013.1-2017.3in Dalian medical university affiliated Dalian health care of women and children from the middle of a pregnancy,threatened abortion information of1023 cases of hospitalized patients,ultrasonic tip for 215 cases of hematoma caused by intrauterine existence,finally determined by access to electronic medical records in hospital childbirth 107 patients involved in the research.According to the location of hematoma,56 cases of retroplacental hematoma were identified as the study group.In the same period,51 cases of hematoma under the subchorion were found in the control group.Collect and collate their clinical datas for comparative analysis.RESULTS:1.Comparison of pregnancy outcomes: retroplacental hematoma is prone to miscarriage(21.4%VS5.9%,P=0.021)and premature delivery(23.2%VS7.8%,P=0.030).2.Comparison of maternal factors:it is no difference between the two groups of age,gestational age,times of pregnancy,the times of uterine cavity operation,the location of the placenta,delivery methods,no difference between the presence of assisted reproductive technology,etc,but the volume of hematoma are obviously different.The volume of hematoma of the retroplacental was 8871.79 ± 438.26mm3,and the hematoma volume of the subchorionic hematoma group was 18284.43±629.58mm3,which was statistically significant(P=0.043,P<0.05).3.Comparison of pregnancy complications: fetal distress in the two groups(13.6%VS2.1%,P=0.037),P<0.05,and the difference was statistically significant.The rest of the pregnancy complication statistics has no obvious difference(P > 0.05),but the placental abruption(11.4%VS4.2 %,RR = 2.28)and fetal intrauterine growth restriction(4.5% VS2.1 %,RR =1.8),placenta previa(11.4% VS4.2 %,RR = 2.28)is greater than the risk of the control group.The risk of gestational diabetes mellitus(13.6%VS2.9%,RR= 0.531)and gestational hypertension(0vs8.3%,RR=0)is significant lower than the control group.4.The birth of contrast: premature rupture of membranes in the team for 18 cases(40.9%),6 cases in the control group(12.5%),P = 0.002,there is a very significant difference statistically significant,premature rupture of membranes shows that the team appear in the risk is significantly higher than the control group.In the study group,the gestational weeks were 37.17 ± 3.34 weeks.In the control group,the gestational weeks were 38.22± 2.71 weeks.The study group was significantly less than the control group(P=0.041),and the difference was statistically significant.Post-placental hematoma is prone to placental abnormality including racquet placenta,fan placenta,front blood vessel,and old blood clots(P=0.004).Two groups of placental residues(29.5% VS 6.3%,P=0.003)were statistically significant,indicating that the study group was more likely to have placental residues.There was no significant difference between the two groups in the mode of delivery,the amount of blood and the manual removal of placenta.5.Comparison of neonatal conditions: there was no significant difference between the two groups of newborn Apgar scores and whether they were enrolled in neonatal pediatrics.The neonatal body weight of the placental hematoma group was 3080.68 ±796.59 g,and the hematoma group was 3364.58 ± 571.10 g,P=0.015,P<0.05,it was statistically significant.Retroplacental hematoma patients are more likely to appear the neonatal diseases,including neonatal intestinal obstruction,neonatal hypoglycemia,neonatal pneumonia,neonatal pulmonary hyaline membrane disease,neonatal hemolysis and so forth(P = 0.019),P < 0.05 which was statistically significant.CONCLUTION:based on two different groups of intrauterine hematoma pregnancy outcome and clinical comparative analysis of the influential factors,the risk of adverse pregnancy outcomes in the retroplacental hematoma is higher than the subchorionic hematoma:(1)the hematoma volume of the retroplacental hematoma is smaller,but retroplacental hematoma prone to adverse pregnancy outcomes: prone to miscarriage and premature birth.(2)fetal distress may occur in the retroplacental hematoma.(3)retroplacental hematoma is more prone to premature rupture of membranes,placental abnormalities and placental remains.(4)in the retroplacental hematoma,the newborn has a lower body weight than subchorionic hematoma and is more likely to develop neonatal disease.