Die prognostische Bedeutung intrauteriner Hämatome des I. und II. Trimenons für den Schwangerschafts- und Geburtsverlauf

The courses of 66 pregnancies with sonographic evidence of an intrauterine haematoma within the egg-membranes during threatened abortion, between 7th and 24th week of gestation, were compared to the courses of 55 patients at the same gestational age admitted to our hospital, during the same period, with vaginal bleeding only. The aim of our study was to determine the prognostic significance of intrauterine haematomata in the I. and II. trimester for the course of pregnancy and delivery. The abortion-rate after intrauterine haematomata was significantly increased to 17.5%, a high percentage of them taking a febrile or septic course. The rate of preterm labour in haematoma patients was significantly higher (34.5 compared to 12.7%, respectively), than that in patients, who were only bleeding; this, furthermore, was reflected by a strong trend of preterm delivery (21.9 compared to 12.9% resp.). The caesarean section rate of 55.8% in the haematoma group was found to be significantly higher than in the control group (16.7%), mainly due to a significantly increased proportion (23.1%) of abnormal foetal presentations. Abnormal placental stages had to be treated significantly more often after intrauterine haematomata (32.6%) than in the control group (9.3%); however, no differences could be found between the two groups in respect of metabolic or respiratory placental dysfunction. The parameters examined in this study were not influenced by the volume of the haematoma, although the spectrum of complications seemed to be correlated to the gestational age at the time of diagnosis.(ABSTRACT TRUNCATED AT 250 WORDS)