Perinatal Outcome Of Intra - Versus Retroplacental Hematomas

IntroductionPlacental hematoma generated in the second trimester is an important complication with tremendous and sometimes unpredictable evolution. This study aims to assess the risk profile of these pregnancies by location.Methods35 patients were diagnosed by ultrasound with placental hematomas between 16 and 20 weeks of gestation. Perinatal outcome was evaluated. Of these, 18 cases had central retroplacental hematoma, 12 peripheral retroplacental hematoma, 5 cases with intraplacental hematoma.ResultsPregnancies complicated with peripheral placental hematomas had the best prognosis, 8 of them with growth restriction, 4 with premature birth, all with good neonatal adaptation.Intraplacental hematomas developed placental insufficiency in most cases, with the highest rate of complications: spontaneous abortion in the second trimester in 3 cases and fetal death in utero in 2 cases. Retroplacental hematomas allowed pregnancy evolution until the onset of trimester 3 in 5 cases, completed by bleeding and premature labor between 32 and 34 weeks with difficult neonatal adaptation; 2 cases resulted in abrupted placenta and intrauterine fetal death in utero at 29 and 31 weeks, 4 miscarriages at 17 weeks of gestation and IUGR in 7 cases.ConclusionsIn conclusion, the occurrence of placental hematoma can dramatically alter the progression and prognosis of a pregnancy, especially in the intraplacental development, with significant damage to the vasculature followed by the introduction of fetal hypoxia and sometimes death in utero.