Journal of IMAB - Annual Proceeding (Scientific Papers)
Publisher: Peytchinski Publishing Ltd.
ISSN:
1312-773X (Online)
Issue:
2026, vol. 32, issue4
Subject Area:
Medicine
-
DOI:
10.5272/jimab.2026324.7191
Published online: 06 November 2026
Original article
J of IMAB. 2026 Oct-Dec;32(4):7191-7195
SUBCHORIONIC HEMATOMA AS AN EARLY MARKER OF PLACENTAL DYSFUNCTION: A PROSPECTIVE COHORT STUDY
Boyan Terziyski1


, Irina Markova2
, Iliana Sokolova3
, Sergei Slavov1,4
,
1) Specialized Hospital for Obstetrics and Gynecology “Maichin Dom”, Sofia, Bulgaria.
2) Medical Center “Trinity”, Sofia, Bulgaria.
3) Department of Health Care, Faculty of Public Health, Medical University, Sofia, Bulgaria.
4) Department of Obstetrics and Gynecology, Faculty of Medicine, Medical University, Sofia, Bulgaria.
ABSTRACT:
Purpose: To evaluate whether subchorionic hematoma (SCH) in early pregnancy is associated with a higher frequency of preeclampsia, preterm birth, small for gestational age (SGA) newborns, placental abruption, and other outcomes related to placental dysfunction.
Material/Methods: A prospective observational study was conducted from December 2020 to July 2025. A total of 460 pregnant women were analyzed, including 178 with SCH and 282 controls without ultrasound evidence of SCH. The frequencies of preeclampsia, preterm birth, SGA, intrapartum complications, and selected associations with SCH size and location were evaluated. Categorical variables were compared using the chi-square test and Fisher’s exact test. A value of p<0.05 was considered statistically significant.
Results: Preeclampsia occurred in 24.2% of women with SCH compared with 7.8% in controls, p=0.001. Preterm birth was observed in 20.2% versus 2.1%, p<0.001. SGA occurred in 37.1% versus 7.1%, p<0.001. Intrapartum complications were more frequent in women with SCH, 11.2% versus 2.8%, p<0.001. Placental abruption accounted for the main difference, 6.7% versus 0.7%, p<0.001. Within the SCH group, a larger hematoma size was significantly associated with preterm birth.
Conclusions: SCH in early pregnancy was associated with a higher frequency of preeclampsia, preterm birth, SGA, and placental abruption. These findings suggest that SCH may identify pregnancies with increased risk of placental dysfunction-related outcomes. Due to the observational design, the results should be interpreted as associations rather than evidence of causality.
Keywords: subchorionic hematoma, placental dysfunction, preeclampsia, preterm birth, small for gestational age, placental abruption, obstetrics and gynecology, ultrasound,
- Download FULL TEXT /PDF 616 KB/
Please cite this article as: Terziyski B, Markova I, Sokolova I, Slavov S. Subchorionic hematoma as an early marker of placental dysfunction: a prospective cohort study. J of IMAB. 2026 Oct-Dec;32(4):7191-7195. [Crossref - 10.5272/jimab.2026324.7191]
Correspondence to: Boyan Terziyski, Specialized Hospital for Obstetrics and Gynecology “Maichin Dom”, Sofia; 2, Zdrave Str., Sofia, Bulgaria. E-mail: boyanterziyski@yahoo.bg
REFERENCES:
1. Pearlstone M, Baxi L. Subchorionic hematoma: a review. Obstet Gynecol Surv. 1993 Feb;48(2):65-68. [PubMed]
2. Mantoni M, Pedersen JF. Intrauterine haematoma. An ultrasonic study of threatened abortion. Br J Obstet Gynaecol. 1981 Jan;88(1):47-51. [PubMed]
3. Xu T, Lun W, He Y. Subchorionic hematoma: Research status and pathogenesis (Review). Med Int (Lond). 2024;4(2):10. [PubMed]
4. Al-Memar M, Vaulet T, Fourie H, Bobdiwala S, Farren J, Saso S, et al. First-trimester intrauterine hematoma and pregnancy complications. Ultrasound Obstet Gynecol. 2020 Apr;55(4):536-545. [PubMed]
5. Nagy S, Bush M, Stone J, Lapinski RH, Gardo S. Clinical significance of subchorionic and retroplacental hematomas detected in the first trimester of pregnancy. Obstet Gynecol. 2003 Jul;102(1):94-100. [PubMed]
6. Eskild A, Vatten LJ. Abnormal bleeding associated with preeclampsia: a population study of 315,085 pregnancies. Acta Obstet Gynecol Scand. 2009;88(2):154-158. [PubMed]
7. Tuuli MG, Norman SM, Odibo AO, Macones GA, Cahill AG. Perinatal outcomes in women with subchorionic hematoma: a systematic review and meta-analysis. Obstet Gynecol. 2011 May;117(5):1205-1212. [PubMed]
8. Norman SM, Odibo AO, Macones GA, Dicke JM, Crane JP, Cahill AG. Ultrasound-detected subchorionic hemorrhage and the obstetric implications. Obstet Gynecol. 2010 Aug;116(2 Pt 1):311-315. [PubMed]
9. Yan X, Xu H, Li J, Xu Z, Niu Y, Wang Y. Subchorionic hematoma and risk of preterm delivery: a systematic review and meta-analysis. Am J Obstet Gynecol MFM. 2023 Jan;5(1):100791. [PubMed]
10. Pan S, Lan Y, Zhou Y, Chen B, Zhou F, Dai D, et al. Associations between the size and duration of asymptomatic subchorionic hematoma and pregnancy outcomes in women with singleton pregnancies. BMC Pregnancy Childbirth. 2023 Aug 2;23(1):555. [PubMed]
11. Liang W, Yan X, Shi Y, Chen B, An L, Huang B, et al. Association between graded subchorionic hematoma and adverse pregnancy outcomes in singleton pregnancies: a prospective observational cohort study. Arch Gynecol Obstet. 2024 Feb;309(2):541-549. [PubMed]
12. White R, Kilgour Venables H. The significance of ultrasound features of sub-chorionic haemorrhage as a predictor of adverse perinatal outcome: A retrospective review. Eur J Obstet Gynecol Reprod Biol. 2023 Oct;289:23-28. [PubMed]
Received: 02 June 2026
Published online: 06 November 2026
back to Online Journal