Abstract：
BACKGROUND: This retrospective single centre study considers the predictive value of specific ultrasound features of sub-chorionic haemorrhage (SCH) as potential indicators of adverse pregnancy outcome.
METHODS: Ultrasound reports and images were reviewed for 160 participants presenting to an early pregnancy assessment unit from January 2018 to January 2019. Participants were selected based upon the presence of SCH within the first trimester. The outcome of each pregnancy and the features of SCH, including the size, location and echogenicity were recorded and multinominal logistic regression was used to establish predictive value.
RESULTS: The majority of participants were asymptomatic and delivered healthy babies. 24% miscarried prior to delivery or had stillborn babies; the features of bleed within this group revealed an increased prevalence of adverse outcome in the presence of moderate sized haemorrhage (p = 0.02). 61% of miscarried pregnancies presented with \"wrapping\" SCH, in which haemorrhage encased the gestation sac, suggesting wrapping posed a probable risk (p = 0.01). 71% of miscarriages occurred within 5 + 0-10 + 0 weeks gestation. Persistent SCH was of greater incidence within those participants with adverse outcome (57%). There was no association between fetal abnormality and miscarriage. Jaundice babies and premature delivery occurred more frequently (p = 0.001) and may be a secondary finding following SCH.
CONCLUSIONS: There was a strong correlation between presence of SCH in early pregnancy and rate of miscarriage. Specific ultrasound features of SCH, most notably a wrapping location with moderate size, may be indicative of increased risk of miscarriage or post-natal complications. Jaundice and premature births may have an association with placental compromise.
METHODS: Ultrasound reports and images were reviewed for 160 participants presenting to an early pregnancy assessment unit from January 2018 to January 2019. Participants were selected based upon the presence of SCH within the first trimester. The outcome of each pregnancy and the features of SCH, including the size, location and echogenicity were recorded and multinominal logistic regression was used to establish predictive value.
RESULTS: The majority of participants were asymptomatic and delivered healthy babies. 24% miscarried prior to delivery or had stillborn babies; the features of bleed within this group revealed an increased prevalence of adverse outcome in the presence of moderate sized haemorrhage (p = 0.02). 61% of miscarried pregnancies presented with \"wrapping\" SCH, in which haemorrhage encased the gestation sac, suggesting wrapping posed a probable risk (p = 0.01). 71% of miscarriages occurred within 5 + 0-10 + 0 weeks gestation. Persistent SCH was of greater incidence within those participants with adverse outcome (57%). There was no association between fetal abnormality and miscarriage. Jaundice babies and premature delivery occurred more frequently (p = 0.001) and may be a secondary finding following SCH.
CONCLUSIONS: There was a strong correlation between presence of SCH in early pregnancy and rate of miscarriage. Specific ultrasound features of SCH, most notably a wrapping location with moderate size, may be indicative of increased risk of miscarriage or post-natal complications. Jaundice and premature births may have an association with placental compromise.
摘要：
背景：这项回顾性单中心研究认为绒毛膜下出血（SCH）的特定超声特征作为不良妊娠结局的潜在指标具有预测价值。
方法：回顾了2018年1月至2019年1月到早孕评估单位就诊的160名参与者的超声报告和图像。根据孕早期SCH的存在选择参与者。每次妊娠的结局和SCH的特征，包括尺寸，记录位置和回声,并采用多因素logistic回归建立预测值.
结果：大多数参与者无症状且分娩健康的婴儿。24％的人在分娩前流产或有死产婴儿；该组中的出血特征显示，在中度出血的情况下，不良结局的患病率增加（p=0.02）。61%的流产妊娠出现“包裹”SCH，其中出血包裹了妊娠囊，提示包裹可能存在风险(p=0.01)。71%的流产发生在妊娠5+0-10+0周。在那些有不良结局的参与者中，持续性SCH的发生率更高(57%)。胎儿异常与流产之间没有关联。黄疸婴儿和早产发生的频率更高（p=0.001），可能是SCH之后的次要发现。
结论：妊娠早期SCH的存在与流产率之间存在很强的相关性。SCH的特定超声特征，最值得注意的是中等尺寸的包装位置，可能表明流产或产后并发症的风险增加。黄疸和早产可能与胎盘妥协有关。
方法：回顾了2018年1月至2019年1月到早孕评估单位就诊的160名参与者的超声报告和图像。根据孕早期SCH的存在选择参与者。每次妊娠的结局和SCH的特征，包括尺寸，记录位置和回声,并采用多因素logistic回归建立预测值.
结果：大多数参与者无症状且分娩健康的婴儿。24％的人在分娩前流产或有死产婴儿；该组中的出血特征显示，在中度出血的情况下，不良结局的患病率增加（p=0.02）。61%的流产妊娠出现“包裹”SCH，其中出血包裹了妊娠囊，提示包裹可能存在风险(p=0.01)。71%的流产发生在妊娠5+0-10+0周。在那些有不良结局的参与者中，持续性SCH的发生率更高(57%)。胎儿异常与流产之间没有关联。黄疸婴儿和早产发生的频率更高（p=0.001），可能是SCH之后的次要发现。
结论：妊娠早期SCH的存在与流产率之间存在很强的相关性。SCH的特定超声特征，最值得注意的是中等尺寸的包装位置，可能表明流产或产后并发症的风险增加。黄疸和早产可能与胎盘妥协有关。
