P04.06: Spontaneous abortion in patients with intrauterine hematomas detected in the first trimester of pregnancy

To evaluate the clinical significance and characteristics of intrauterine hematomas detected in the first trimester of pregnancy. A prospective study was designed to compare the obstetrical outcome in 43 pregnant women with intrauterine hematoma, who spontaneously aborted to 187 controls, who delivered after the hematoma was diagnosed. Statistical analysis was assessed by ÷2 analysis and two-tailed Fisher's exact test. Means of continuous variables were compared by two-tailed Student's t-test. Smoking and multiparity were significantly greater in the abortion group. There was no significant difference with regard to maternal age, and medical history such as chronic hypertension (P = 0.66), gestational diabetes (P = 0.31), termination of pregnancy (P = 0.86), previous loss (P = 0.39) and perinatal death (P = 0.35). Retroplacental (P = 0.72) or subchorionic (P = 0.72) position of the hematoma was not significantly correlated with an increased risk for spontaneous abortion. The cervical (P = 0.004) and posterior (P = 0.002) location of the hematoma has significantly influenced the risk of abortion. The abortion rate was significantly greater in those who were spotting (P = 0.02), bleeding (P = 0.03) or crumping (P = 0.001), but not in those who were discharging (P = 0.1). Among patients having no symptoms the rate of abortion was significantly lower (P = 0.02). The volume ratio of the haematoma and the gestational sac was significantly greater in the abortion group (p < 0.001). Our study suggests that the presence and the characteristic of an intrauterine hematoma during the first trimester may identify a population of patients at increased risk for adverse pregnancy outcome.