• Etiological factors of the formation of retrochorial hematomas in the first trimester of pregnancy
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Etiological factors of the formation of retrochorial hematomas in the first trimester of pregnancy

Ukrainian Journal of Perinatology and Pediatrics. 2026.1(105): 38-46. doi: 10.15574/PP.2026.1(105).3846
Romanenko T. G., Staselovych L. Y., Zhaloba H. M.
Shupyk National Healthcare University of Ukraine, Kyiv

For citation: Romanenko TG, Staselovych LY, Zhaloba HM. (2026). Etiological factors of the formation of retrochorial hematomas in the first trimester of pregnancy. Ukrainian Journal of Perinatology and Pediatrics. 1(105): 38-46. doi: 10.15574/PP.2026.1(105).3846.
Article received: Dec 03, 2025. Accepted for publication: Feb 16, 2026.

Aim – to establish the etiological factors of the formation of RCH in the first trimester of pregnancy in order to reduce the frequency of their occurrence.
Materials and methods. Clinical observation was conducted in 164 pregnant women (main group, МG) with RCH who were undergoing examination and treatment and 48 pregnant women (control group, CG) who did not have RCH in the first trimester of pregnancy, for the period from 2022 to 2024. A clinical and statistical analysis of somatic, gynecological and reproductive anamnesis was conducted in 212 pregnant women to clarify the etiological factors of the development of RCH in them; the following anamnesis was collected: reproductive, gynecological, somatic, thrombotic (personal and family).
Results. Among 212 pregnant women, infertility was detected in 45 (21.2%): in 38 (23.2%) in pregnant МG and in 7 (14.6%) in CG. Early pregnancy loss was significantly more often noted in the anamnesis in pregnant МG – 26 (15.8%) cases versus 4 (8.4%) in CG. Uterine leiomyoma was significantly more often observed in pregnant МG – 15 (9.1%) cases versus 3 (6.3%) in CG; the frequency of chronic endometritis in pregnant women in the МG was 40 (24.4%) cases versus 5 (10.4%) cases in the CG, which is significantly lower. The high frequency of uterine cavity wall scraping in the anamnesis in both studied groups – in 86 pregnant women (52.4%) in the МG and in 11 pregnant women (22.9%) in the CG. Weight and body mass index (BMI) were significantly lower in pregnant МG.
Conclusions. The etiological factors of retrochorial hematomas were: antiphospholipid syndrome in 11.6% of cases, congenital thrombophilia in 16.5% of cases, infectious-inflammatory factor in 53.7% of cases, uterine developmental anomalies in 2.4% of cases, unspecified causes in 15.8% of cases.
The study was performed in accordance with the principles of the Declaration of Helsinki. The study protocol was approved by the Local Ethics Committee of the institution mentioned in the work.
The authors declare no conflict of interest.
Keywords: chorionic detachment, retrochorial hematoma, etiological factors, anamnesis, somatic, gynecological, reproductive, thrombotic; antiphospholipid syndrome, congenital thrombophilia, infectious-inflammatory factor.

REFERENCES

1. Chandramathi P, Devi VR, Vaishnavi P. (2021). Maternal and perinatal outcomes in women with first trimester vaginal bleeding. Int J Clin Obstet Gynaecol. 5(6): 8-10. https://doi.org/10.33545/gynae.2021.v5.i6a.1049

2. Duka YuM, Yushchenko MI. (2023). Analysis of perinatal outcomes in women with high and critical levels of the sFlt-1/PlGF ratio. Ukrainian Journal Health of Woman. 1(164): 21-27. https://doi.org/10.15574/HW.2023.164.21

3. Günay T, Yardımcı OD. (2021, Jan 8). How does subchorionic hematoma in the first trimester affect pregnancy outcomes? Arch Med Sci. 18(3): 639-646. https://doi.org/10.5114/aoms/113645; PMid:35602250 PMCid:PMC9107020

4. Hendriks E, MacNaughton H, MacKenzie MC. (2019). First trimester bleeding: evaluation and management. Am Assoc Fam Physician:99(3):166-174.

5. Kavyashree HS. Rajeshwari K. (2019). A study on pregnancy outcome in patients with first trimester vaginal bleeding. Int J Reprod Contracept Obstet Gynecol. 8(3): 820-824. https://doi.org/10.18203/2320-1770.ijrcog20190524

6. Koshova I, Lubkovska O. (2022). Features of retrochoir hematomas and their effect on the course of pregnancy. EUREKA: Health Sciences. (4): 18-25. https://doi.org/10.21303/2504-5679.2022.002590

7. Kumari D, Chithra DS, Gayathri DS. (2023, Sep). Analysis of First Trimester Bleeding – A Prospective Observational Study in Indian Population. International Journal of Science and Research (IJSR). 12(9). https://doi.org/10.21275/SR23915090310

8. Liang W, Yan X, Shi Y, Chen B, An L et al. (2024, Feb). Association between graded subchorionic hematoma and adverse pregnancy outcomes in singleton pregnancies: a prospective observational cohort study. Arch Gynecol Obstet. 309(2): 541-549. Epub 2023 Feb 23. https://doi.org/10.1007/s00404-023-06943-8; PMid:36821010 PMCid:PMC10808168

9. Liu Y, Tong A, Qi X. (2020). A large subchorionic hematoma in pregnancy. Medicine, 99 (22), e20280. https://doi.org/10.1097/MD.0000000000020280; PMid:32481396 PMCid:PMC12245357

10. Li Y, Wang E, Huang S, Zhu C, Zhang K, Zhang J et al. (2021). Autoantibodies in association with subchorionic haematoma in early pregnancy. Ann Med. 53: 841-847. https://doi.org/10.1080/07853890.2021.1936150; PMid:34085897 PMCid:PMC8183528

11. Majumder S. (2021, Nov). Socioeconomic status scales: Revised Kuppuswamy, BG Prasad, and Udai Pareekh's scale updated for 2021. J Family Med Prim Care. 10(11): 3964-3967. Epub 2021 Nov 29. https://doi.org/10.4103/jfmpc.jfmpc_600_21; PMid:35136753 PMCid:PMC8797108

12. Matar M, Yared G, Massaad C, Ghazal K. (2025, Feb). Vaginal bleeding during pregnancy: a retrospective cohort study assessing maternal and perinatal outcomes. J Int Med Res. 53(2): 3000605251315349. https://doi.org/10.1177/03000605251315349; PMid:39921410 PMCid:PMC11806467

13. Mintser OP. (2018). Statystychni metody doslidzhennia pry vykonanni naukovykh robit. Praktychna medytsyna. 8: 112-118.

14. Naert MN, Khadraoui H, Muniz Rodriguez A, Naqvi M, Fox NS. (2019). Association Between First-Trimester Subchorionic Hematomas and Pregnancy Loss in Singleton Pregnancies. Obstetrics & Gynecology. 134(2): 276-281. https://doi.org/10.1097/AOG.0000000000003360; PMid:31306310

15. Nagy S, Bush M, Stone J, Lapinski RH, Gardó S. (2003). Clinical significance of subchorionic and retroplacental hematomas detected in the first trimester of pregnancy. Obstetrics & Gynecology. 102(1): 94-100. https://doi.org/10.1016/S0029-7844(03)00403-4; PMid:12850613

16. Naskar A, Chowdhury R, Kumar Saha P, Das RK. (2022, Sep). Evaluation of Pregnancy Outcome in Women with First Trimester Vaginal Bleeding: A Longitudinal Study at a Tertiary Care Hospital, Kolkata, India. Journal of Clinical and Diagnostic Research. 16(9): QC11-QC16. https://doi.org/10.7860/JCDR/2022/57184.16906

17. Pan S, Lan Y, Zhou Y, Chen B, Zhou F et al. (2023, Aug 2). Associations between the size and duration of asymptomatic subchorionic hematoma and pregnancy outcomes in women with singleton pregnancies. BMC Pregnancy Childbirth. 23(1): 555. https://doi.org/10.1186/s12884-023-05831-y; PMid:37532977 PMCid:PMC10394775

18. Patel NG, Patel MS, Shah SR, Jani SK, Patel JA, Shah JU. (2014). Study of outcome of pregnancy in patients with first-trimester bleeding per vaginum. Int J Adv Med. 1: 230-233. https://doi.org/10.5455/2349-3933.ijam20141111

19. Qin ZJ, Xu Y, Du Y, Chen YL, Sun L, Zheng A. (2022, Jun 17). Intrauterine Hematoma in the First Trimester and Pregnancy Complications: A Systematic Review and Meta-Analysis. Front Med (Lausanne). 9: 892146. https://doi.org/10.3389/fmed.2022.892146; PMid:35783643 PMCid:PMC9247277

20. Sayyad H, Jadoon H, Gul M, Bibi M, Rehman S, Zafar S. (2023). Pregnancy Outcome in First Trimester Bleed. Pakistan Journal of Medical & Health Sciences. 17(05): 666. https://doi.org/10.53350/pjmhs2023175666

21. Umeshchandra S, Patil LD. (2022). A Study of Maternal and Foetal Outcome in Pregnant Women with History of First Trimester Vaginal Bleeding. Journal of Evolution of Medical and Dental Sciences. 11(8): 728-737. https://doi.org/10.14260/jemds.v11i8.165

22. Vdovychenko SIu, Talko OV. (2024). Vplyv retrokhorialnykh hematom u I trymestri na perynatalni naslidky rozrodzhennia. Perynatolohiia ta reproduktolohiia: vid naukovykh doslidzhen do praktyky. 4; 3-1. https://doi.org/10.52705/2788-6190-2024-03.1-06

23. Wei W, Qiu XC, Tang N, Liang Z, Wu J, Huang P. (2025). Incidence of subchorionic hematoma and contributing factors in assisted reproductive technologies – a retrospective cohort study. Front. Med. 12: 1569789. https://doi.org/10.3389/fmed.2025.1569789; PMid:40337279 PMCid:PMC12055540

24. Yin R, Wang K, Li L, Dang Y, Wang B, Sheng Y et al. (2022). Association between first-trimester subchorionic hematoma detected at 6-8 weeks of gestation and pregnancy outcomes after fresh embryo transfers: a propensity score-matching cohort study. Arch Gynecol Obstet. 306: 2167-2175. https://doi.org/10.1007/s00404-022-06775-y; PMid:36112208

25. Yoshihara T, Okuda Y, Yoshino O. (2024). Quantification of the size of subchorionic hematoma causing pregnancy-related complications: a retrospective cohort study. J Med Ultrasonics. 51: 649-654. https://doi.org/10.1007/s10396-024-01488-y; PMid:39190239 PMCid:PMC11968545

26. Yushchenko MI, Duka YuM. (2023). Assessment of genetic susceptibility to the occurrence of placenta-associated complications in pregnant women with retrochorial hematomas in the trimester I of pregnancy. Ukrainian Journal of Perinatology and Pediatrics. 1(93): 12-18. https://doi.org/10.15574/PP.2023.93.12

27. Zhong C, Xiong G, Lin L, Li Q, Chen X, Zhang X et al. (2022). The association of maternal vaginal bleeding and progesterone supplementation in early pregnancy with offspring outcomes: A prospective cohort study. BMC Pregnancy Childbirth. 22(1): 390. https://doi.org/10.1186/s12884-022-04711-1; PMid:35513779 PMCid:PMC9074309