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Emerg Radiol 2019 Feb 29;26(1):87-97. Epub 2018 Aug 29.

Department of Radiology, University of Washington Medical Center, 1959 NE pacific St., Seattle, WA, 98195, USA.

Placental and periplacental bleeding are common etiologies for antepartum bleeding. Placental abruption complicates approximately 1% of pregnancies and is associated with increased maternal, fetal, and neonatal morbidity and mortality. This article reviews the normal placental appearance on ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI) and then discusses the different morphological appearance of placental and periplacental hematomas along with their mimics. Read More

Int J Gynaecol Obstet 2018 06 13;141(3):391-392. Epub 2018 Mar 13.

Department of Ultrasound Diagnosis, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China.

J Ultrasound Med 2018 Jul 17;37(7):1725-1732. Epub 2018 Jan 17.

Departments of Radiology, Obstetrics and Gynecology , Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.

Objectives: To evaluate and compare grading systems of subchorionic hematoma (SCH) on first-trimester ultrasound examinations with live embryos to assess which best correlates with early pregnancy outcome and to assess the effect of gestational age at the time of diagnosis on outcome.

Methods: First-trimester live singleton pregnancies between 6 and 11 weeks' gestational age with SCH were identified by an institutional database search. First-trimester outcome was categorized as "live" or "demise" based on ultrasound or medical record documentation. Read More

Pediatr Dev Pathol 2017 Sep-Oct;20(5):387-393. Epub 2017 Mar 20.

2 Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.

Background The pathology that underlies morbidly adherent placenta (MAP) is poorly understood. The objective of this study was to describe the placental pathology, especially implantation site pathology, associated with MAP. Methods This was a single institution, retrospective case-control study design examining placentas of patients who delivered between January 2008 and September 2013. Read More

J Matern Fetal Neonatal Med 2018 Jul 19;31(13):1715-1719. Epub 2017 May 19.

d Department of Obstetrics and Gynecology , İzmir Tepecik Training and Research Hospital , İzmir , Turkey.

Purpose: To investigate the relationships of TNF-related weak inducer of apoptosis (sTWEAK), a cytokine related to the TNF superfamily, its newly described soluble receptor sCD163, and the sTWEAK/sCD163 ratio with perinatal outcomes in women with first-trimester vaginal bleeding.

Materials And Methods: Seventy (41 threatened abortion and 29 control) gestational-age-matched (6-14 weeks) pregnant women were included in the study. Antenatal complications (gestational diabetes, preeclampsia, intrauterine growth restriction, oligohydramniosis, polyhydramniosis), and perinatal outcomes (delivery mode, birth weight, delivery week) were recorded. Read More

J Obstet Gynaecol Res 2016 Dec 20;42(12):1652-1656. Epub 2016 Sep 20.

Department of Obstetrics, Osaka Medical Center and Research Institute for Maternal and Child Health, Osaka, Japan.

Aim: To investigate the association between uterine bleeding preceding fetoscopic laser photocoagulation (FLP) and the presence of discolored amniotic fluid that impedes FLP.

Methods: A retrospective review of all multiple gestations requiring FLP at the present institution was conducted. The rate of low visibility because of discolored amniotic fluid at the beginning of FLP was compared between patients with and without a history of uterine bleeding, defined as either genital bleeding or ultrasonographically detected subchorionic hematoma. Read More

Pediatr Dev Pathol 2016 Jul 21. Epub 2016 Jul 21.

4 Northwestern University.

Background: The pathology that underlies morbidly adherent placenta (MAP) is poorly understood. The objective of this study was to describe the placental pathology, especially implantation site pathology, associated with MAP.

Methods: This was a single institution, retrospective case-control study design examining placentas of patients who delivered between January 2008 and September 2013. Read More

Zhonghua Yi Xue Za Zhi 2016 May;96(17):1383-5

Obstetrics and Gynecology Hospital, Fudan University, Shanghai 200090, China.

Objective: To study the effects of subchorionic hematoma (SCH) on pregnancy outcome.

Methods: We searched publications from January 2000 to July 2015 for cohort and case-control studies evaluating subchorionic hematoma and perinatal outcomes, including spontaneous abortion, premature delivery and delivery mode.

Results: Data of 6 articles analyzed by meta-analysis showed that SCH group had higher rate of spontaneous abortion, while no difference in premature delivery and delivery mode, compared with threatened abortion group. Read More

Eur Rev Med Pharmacol Sci 2016 04;20(8):1656-63

Department of Chemistry and Pharmaceutical Technologies, University of Ferrara, Ferrara, Italy.

Objective: Alpha Lipoic Acid (ALA) is a safe natural molecule that exerts a selective immunomodulating activity with antioxidant and anti-inflammatory properties. This randomized controlled clinical trial (RCT) tested the effect of the vaginal administration with ALA or Progesterone, in subchorionic hematoma resorption in women with threatened miscarriage.

Patients And Methods: 400 mg of vaginal Progesterone or 10 mg of vaginal ALA were administered to sixty-two pregnant women, in the first trimester of gestation with threatened miscarriage and subchorionic hematoma. Read More

Fertil Steril 2016 07 7;106(1):140-143. Epub 2016 Apr 7.

Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.

Objective: To examine the association between first-trimester bleeding and live-birth rates in twin pregnancies conceived with in vitro fertilization (IVF).

Design: Retrospective cohort study.

Setting: Academic infertility practice. Read More

J Clin Endocrinol Metab 2016 06 6;101(6):2612-21. Epub 2016 Apr 6.

The Cecil H. and Ida Green Center for Reproductive Biology, Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, Texas 75390-9032.

Context: Nrf2 is a key transcription factor that modulates cell defense mechanisms against endogenous and exogenous stress. Previously, we reported that thrombin increased matrix metalloproteinases and prostaglandin synthesis in human amnion mesenchymal cells.

Objective: We sought to determine whether activation of Nrf2 alters the effect of thrombin on prostaglandin synthesis, protease activation, and cytokine release in human amnion. Read More

J Matern Fetal Neonatal Med 2017 Feb 28;30(4):406-410. Epub 2016 Apr 28.

a Reproductive Medicine Center, Department of Obstetrics and Gynecology, Drum Tower Hospital Affiliated to Nanjing University Medical College , Nanjing , Jiangsu , PR China.

Objective: The aim of this retrospective cohort study was to assess the effect of subchorionic hematoma (SCH) on pregnancy outcomes in IVF/ICSI patients.

Methods: We retrospectively analyzed 1097 pregnancies achieved by in vitro fertilization and embryo transfer (IVF-ET) or frozen-thawed embryo transfers (FETs) between January 2013 and June 2013 at the IVF center of Nanjing Drum Tower Hospital. The prevalence of SCH was 12. Read More

Rinsho Ketsueki 2016 Jan;57(1):31-5

Department of Obstetrics and Gynecology, Japan Baptist Hospital.

Blood coagulation factors play an essential role in pregnancy. We describe a 30-year-old pregnant woman whose course was complicated by dysfibrinogenemia with polymorphism of fibrinogen AαThr312Ala (rs6050) GG genotype. She was admitted to our hospital for genital bleeding and a huge subchorionic hematoma at 6 gestational weeks. Read More

Fertil Steril 2016 05 25;105(5):1241-1246. Epub 2016 Jan 25.

Department of Obstetrics and Gynecology, Fertility Associates of Memphis, Vanderbilt University, Memphis, Tennessee.

Objective: To determine the frequency of subchorionic hematomas (SCH) in first-trimester ultrasound examinations of patients with infertility and recurrent pregnancy loss (RPL) and in patients from a general obstetric population. To determine if the method of assisted reproduction utilized or the use of anticoagulants, such as heparin and aspirin (ASA), influenced frequency of SCH.

Design: Prospective, cohort study. Read More

Emerg Radiol 2016 Apr 19;23(2):105-9. Epub 2015 Nov 19.

Department of Radiology, University of California, San Diego Medical Center, 200 West Arbor Drive, San Diego, CA, 92103, USA.

The pregnant abdominal trauma patient presents a unique diagnostic challenge. This study aimed to evaluate the accuracy of abdominal sonography for the detection of clinically important injuries in pregnant abdominal trauma patients. A retrospective review was performed of a trauma center database from 2001 to 2011. Read More

Eur Rev Med Pharmacol Sci 2015 Sep;19(18):3426-32

Department of Obstetrics and Gynecology, University of Perugia, Perugia, Italy.

Objective: The clinic use of alpha Lipoic Acid (ALA) is linked to its capability to exert antioxidant effects and, more interestingly, to counteract the pathologic changes of complex networks of cytokines, chemokines and growth factors, restoring their physiological state. The aim of this randomized controlled clinical trial was to test the contribution of oral supplementation of ALA to the standard treatment with Progesterone vaginal suppositories, in healing subchorionic hematomas in patients with threatened miscarriage. Controls were administered only Progesterone suppositories. Read More

Ultrasound Q 2016 Mar;32(1):43-6

Departments of *Radiology and †Reproductive Medicine, University of California, San Diego, San Diego, CA; and ‡Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX.

Objectives: The aims of this study were to determine the incidence of placental sonolucencies on first-trimester screening sonograms in a general obstetric population and assess whether these findings are associated with adverse obstetric outcomes.

Methods: A retrospective cohort analysis of 201 pregnant patients screened at a high-risk prenatal diagnostic center was conducted with first-trimester cine clips reviewed by 2 radiologists. Placental sonolucencies were defined as intraplacental anechoic or heterogeneous areas 0. Read More

Am J Obstet Gynecol 2015 Sep 14;213(3):403.e1-4. Epub 2015 May 14.

Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL.

Objective: The objective of the study was to evaluate the association between a sonographically diagnosed subchorionic hematoma (SCH) in the first trimester and subsequent midtrimester cervical length and preterm birth.

Study Design: In this cohort study, 512 women with an SCH on their first-trimester ultrasound were compared with 1024 women without a first-trimester SCH. All women underwent routine transvaginal cervical length measurement between 18 and 22 weeks. Read More

Clin Imaging 2015 Mar-Apr;39(2):176-85. Epub 2014 Oct 23.

Department of Radiology, Montefiore Medical Center, Albert Einstein College of Medicine.

Ultrasound is the primary imaging modality used in the evaluation of first-trimester vaginal bleeding and pelvic pain. This article will summarize the ultrasound findings in normal first-trimester pregnancy, failed pregnancy, ectopic pregnancy, subchorionic hemorrhage, retained products of conception, and gestational trophoblastic disease. Mastery of the spectrum of sonographic findings in the normal and abnormal first-trimester pregnancy allows the radiologist to make accurate diagnoses and helps to appropriately guide patient management. Read More

PLoS One 2014 4;9(11):e111676. Epub 2014 Nov 4.

Reproductive Medicine Center, the First Affiliated Hospital of Anhui Medical University, Hefei, China.

Objective: To evaluate the predictive value of the symptoms of an intrauterine hematoma (IUH) for adverse pregnancy outcomes.

Methods: A literature review was performed with the search terms, including intrauterine/subchorionic/retroplacental/subplacental hematoma/hemorrhage/bleeding/collection/fluid, covering the period from January, 1981 to January, 2014. We just focused on the pregnancy outcomes associated with different symptoms of an IUH. Read More

Eur J Obstet Gynecol Reprod Biol 2014 Oct 30;181:41-4. Epub 2014 Jul 30.

Department of Obstetrics and Gynecology, Graduate School of Medical Science, University of the Ryukyus, Nishihara, Okinawa, Japan.

Objective: Obstetric complications occur more frequently in pregnancies after in vitro fertilization (IVF). We attempted to determine the correlation between subchorionic hematoma and IVF pregnancies.

Study Design: We analyzed 194 pregnancies achieved by infertility treatment between January 2008 and February 2012 at our hospital. Read More

J Matern Fetal Neonatal Med 2015 Jul 14;28(10):1219-23. Epub 2014 Aug 14.

a Department of Pediatrics and Adolescent Medicine .

Objective: Placental anomalies visualized at midgestation by MRI are shown to be related to pregnancy outcome. We performed a prospective cohort study to investigate the influence of placental pathologies diagnosed with fetal MRI on long-term neurodevelopmental outcome.

Methods: In our hospital-based, cross-sectional study, all fetal MRI examinations of pregnancies with vascular placental pathology (i. Read More

Ginekol Pol 2013 Nov;84(11):944-9

Klinika Medycyny Płodu i Ginekologii I Katedry Ginekologii i Połoznictwa Uniwersytetu Medycznego w Łodzi, Polska.

Objectives: the aim of this retrospective study was to assess if a first trimester subchorionic hematoma (SCH) influences the pregnancy outcome and whether pv bleeding can be a prognostic factor for the pregnancy course.

Material And Methods: the study included 185 pregnant women hospitalized due to symptoms of a threatening miscarriage. Patients were divided into 2 groups: 119 women with SCH (study group) and 66 patients with normal prenatal scan (control group), further subdivided into cases with and without pv bleeding, irrespectively of the outcome of the ultrasound scan. Read More

Obstet Gynecol 2014 Feb;123(2 Pt 2 Suppl 2):458-62

Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.

Background: Cervical varices are an extremely rare complication of pregnancy; they can result in significant maternal morbidity secondary to acute hemorrhage. There is limited evidence to guide the management of cervical varices during termination of pregnancy.

Case: A 37-year-old woman presented with recurrent vaginal hemorrhage at 17 weeks of gestation in the setting of a dichorionic-diamniotic twin gestation, an anterior placenta previa, a subchorionic hematoma visible on ultrasound examination, and prominent cervical varices. Read More

Eur J Obstet Gynecol Reprod Biol 2014 Jan 31;172:36-9. Epub 2013 Oct 31.

Department of Obstetrics and Gynaecology, Graduate School of Medicine, University of the Ryukyus, Nishihara, Okinawa, Japan.

Objectives: Increased incidence of preterm birth, pregnancy-induced hypertension (PIH) and small-for-gestational-age (SGA) babies have been reported in women with endometriosis, but the study populations included women in whom a definitive diagnosis was not attainable, and women who conceived via in vitro fertilization/embryo transfer (IVF/ET), which, in itself, is a risk factor for adverse pregnancy outcome. Thus there is a lack of consensus on the effects of endometriosis on pregnancy outcome. This study compared the pregnancy outcomes of women with or without a definitive diagnosis of endometriosis on laparoscopy. Read More

Ultrasound Q 2013 Dec;29(4):293-301

*Baptist Hospital of Miami/South Miami Center for Women and Infants, Miami, Florida; †Walter Reed National Military Medical Center, Bethesda, Maryland; ‡Sunnybrook Health Sciences Centre, Bayview Campus, Toronto, Ontario, Canada; §University of Washington School of Medicine, Seattle, Washington; ∥Massachusetts General Hospital, Boston Massachusetts; ¶Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire; #George Washington University Hospital, Washington, District of Columbia; **Thomas Jefferson University Hospital, Philadelphia, Pennsylvania; ††Massachusetts General Hospital, Boston Massachusetts; ‡‡Memorial Sloan Kettering Cancer Center, New York, New York; §§Brigham & Women's Hospital, Boston, Massachusetts, American College of Obstetrics and Gynecology; ∥∥Mallinckrodt Institute of Radiology, St. Louis, Missouri; ¶¶Columbia University, New York, New York, American College of Obstetrics and Gynecology; ##Mayo Clinic, Rochester, Minnesota; ***University of Maryland School of Medicine, Baltimore, Maryland; and †††Valley Hospital, Ridgewood, New Jersey, American College of Obstetrics and Gynecology.

Vaginal bleeding occurring in the second or third trimesters of pregnancy can variably affect perinatal outcome, depending on whether it is minor (i.e. a single, mild episode) or major (heavy bleeding or multiple episodes. Read More

Arch Gynecol Obstet 2014 Feb 26;289(2):307-11. Epub 2013 Jul 26.

Perinatal Center for Maternity and Neonate, Yokohama City University Medical Center, 4-57 Urafunecyou, Minami-ku, Yokahama, Kanagawa, 232-0024, Japan,

Objective: To examine the clinicopathological characteristics of pregnant women who presented with intermittent hemorrhage occurring throughout pregnancy until delivery.

Method: A total of 24 women with intermittent hemorrhage occurring throughout pregnancy were categorized into two groups, a group with persistent subchorionic hematoma (PSH) and another with chronic abruption (CA), and the pregnancy outcomes were compared between the two groups. The data were expressed as medians (range). Read More

Prenat Diagn 2013 Oct 3;33(10):973-8. Epub 2013 Jul 3.

Fetal Medicine Unit, Mount Sinai Hospital, University of Toronto, Ontario, Canada.

Objectives: To review the association between ultrasound findings, placental pathology, and prognosis in pregnancies complicated by massive subchorionic thrombohematoma (MTH)/Breus' mole.

Method: We identified 14 cases of MTH from January 2004 to December 2012. MTH was defined by >1 cm thickness hematoma and extensive (≥50%) involvement of the fetal surface of the placenta. Read More

Taiwan J Obstet Gynecol 2013 Mar;52(1):154-6

Department of Medicine, Mackay Medical College, New Taipei City, Taiwan.

Emerg Med Clin North Am 2012 Nov;30(4):837-47

Harvard Medical School, Boston, MA, USA.

First-trimester vaginal bleeding and abdominal pain are common complaints in the emergency department. The differential diagnosis is broad, ranging from benign conditions to life-threatening complications. This is a difficult topic because it is charged not only with immediate emotional connotations but also with potential long-term effects on the patient's ability to become pregnant again. Read More

J Comput Assist Tomogr 2012 May-Jun;36(3):330-3

Department of Radiology, Kitano Hospital, Osaka, Japan.

Massive subchorionic thrombosis is a rare condition, defined as a large thrombus confined to the subchorionic space. It is associated with poor perinatal prognosis. However, prenatal diagnosis by ultrasonography is often difficult. Read More

J Obstet Gynaecol 2012 Apr;32(3):304-5

Department of Obstetrics and Gynecology, Japanese Red Cross Katsushika Maternity Hospital, Tokyo, Japan.

Thromb Res 2012 Apr 17;129(4):e161-3. Epub 2011 Nov 17.

J Obstet Gynaecol Res 2012 Jan 14;38(1):180-4. Epub 2011 Oct 14.

Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, Nasushiobara, Japan.

Aim: The aim of this study was to investigate the etiological characteristics of patients diagnosed with subchorionic hematoma.

Methods: A case-controlled study was performed to compare characteristics of patients and controls. Via ultrasound examination, 47 pregnant patients were found to have subchorionic hematomas and 1075 had no evidence of subchorionic hematomas (controls). Read More

J Pharm Bioallied Sci 2011 Jul;3(3):329-38

Department of Radiology, Government Medical College and Rajindra Hospital, Punjab, India.

Objectives: Examination of pregnant women in the first trimester with transvaginal ultrasonography with the aim to study various fetal development markers, e.g., gestation sac, yolk sac, fetal heart motion, CRL length, and fetal anatomy in both normal and abnormal pregnancies. Read More

Ultrasound Obstet Gynecol 2012 Jan;39(1):112-4

J Obstet Gynaecol Can 2011 May;33(5):475-479

Department of Obstetrics and Gynaecology, Mount Sinai Hospital, University of Toronto, Toronto ON.

Background: Small hematomas on the placental surface, termed subamniotic hemorrhage, are a common finding either at the routine 18- to 20-week anatomy ultrasound or at subsequent assessments of fetal growth and well-being. Hemorrhage beneath or at the edge of the placenta, or behind an isolated area of the fetal membranes, is of greater concern.

The Cases: We describe the ultrasound findings and clinical outcomes in two women with a diagnosis of massive intrauterine hematoma arising from the fetal membranes. Read More

Acta Obstet Gynecol Scand 2011 Aug 20;90(8):927-8; author reply 928-9. Epub 2011 May 20.

Obstet Gynecol 2011 May;117(5):1205-12

Department of Obstetrics and Gynecology, Washington University in St. Louis, St. Louis, Missouri 63110, USA.

Objective: To estimate the association between subchorionic hematoma and adverse perinatal outcomes.

Data Sources: MEDLINE, EMBASE, and the Cochrane Library.

Methods Of Study Selection: We searched English language publications from January 1981 to August 2010 for cohort and case-control studies evaluating subchorionic hematoma and perinatal outcomes. Read More

J Obstet Gynaecol 2011 ;31(3):210-2

Department of Obstetrics and Gynaecology, Etlik Zübeyde Hanım Maternity and Women's Health Teaching and Research Hospital, Ankara, Turkey.

Subchorionic haemorrhage in the 1st trimester of pregnancy can be seen in some patients and the significance of it is controversial. In this study, subchorionic haemorrhage was found to be significantly associated with increased risk of miscarriage and IUGR. On the other hand, we did not see a significant relation between pre-term labour and subchorionic haemorrhage. Read More

Ginekol Pol 2010 Dec;81(12):902-6

Instytut Centrum Zdrowia Matki Polki, Klinika Połoznictwa i Ginekologii w Łodzi.

Objectives: The aim was to present pregnancy complications and outcome in the group of women with subchorionic hematoma (SCH) diagnosed in the first or second trimester of pregnancy

Methods: A retrospective study was performed to compare the perinatal outcome of 41 patients with SCH (study group) with 59 women treated of threatening abortion (control group). Age, obstetric history the course of pregnancy and obstetric outcomes were analyzed.

Results: More SCH patients lost the pregnancy before 22 weeks gestation when Compared to the control group (39. Read More

Fertil Steril 2011 Jun 26;95(7):2429.e9-13. Epub 2011 Feb 26.

Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, California 90033, USA.

Objective: To report a case of endometriosis in para-aortic lymph nodes during pregnancy.

Design: Case report.

Setting: Tertiary care center. Read More

Kathmandu Univ Med J (KUMJ) 2011 Jan-Mar;9(33):41-4

Department of Gynaecology and Obstetrics, Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Kavre, Nepal.

Background: Threatened abortion is the most common complication in the first half of pregnancy. Most of these pregnancies continue to term with or without treatment. Spontaneous abortion occurs in less than 30% of these women. Read More

Ultrasound Obstet Gynecol 2011 Jun 16;37(6):717-22. Epub 2011 Mar 16.

Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria.

Objective: To evaluate the relationship between placental vascular pathology detected by prenatal magnetic resonance imaging (MRI) and perinatal outcome.

Methods: This was a retrospective, hospital-based, cross-sectional study in which all fetal MRI examinations of singleton pregnancies with vascular placental pathology (i.e. Read More

Acta Obstet Gynecol Scand 2010 Oct;89(10):1357-61

Department of Obstetrics and Gynecology, The Chinese University of Hong Kong, Hong Kong.

A retrospective audit identified 10 cases of massive idiopathic subchorionic thrombohematoma. The incidence was 1:3,133. Only six of these pregnancies resulted in a livebirth and only two reached term. Read More

Obstet Gynecol 2010 Aug;116(2 Pt 1):311-5

Department of Obstetrics and Gynecology, Washington University, St Louis, Missouri, USA.

Objective: To estimate the association between the ultrasonographic diagnosis of subchorionic hemorrhage and adverse pregnancy outcomes.

Methods: This was a retrospective cohort study of all consecutive women undergoing routine ultrasonography before 22 weeks with a singleton gestation at one institution from 1994 to 2008. Presence or absence of subchorionic hemorrhage defined the two study groups. Read More

J Matern Fetal Neonatal Med 2010 Jul;23(7):717-9

Yeditepe University Hospital, Department of Obstetrics and Gynecology, Istanbul, Turkey.

Subchorionic hematoma might be associated with poor pregnancy outcome. Two intra cytoplasmic sperm injection pregnancies complicated with subchorionic hematoma were found to have elevated mid-trimester maternal serum alpha-fetoprotein levels. One of them had miscarriage at 16 weeks' gestation and the other delivered a healthy baby by cesarean section. Read More

West J Emerg Med 2008 May;9(2):115-7

Baylor Medical Center at Garland.

This case study describes a pregnant patient with vaginal bleeding who had a bedside endovaginal ultrasound in the emergency department (ED). The emergency physician identified a live intra-uterine pregnancy (IUP) with another structure that appeared to be a second gestational sac. The patient subsequently had an endovaginal ultrasound in the radiology department 46 minutes later. Read More

Am Fam Physician 2009 Jun;79(11):985-94

Department of Family Medicine, University of Colorado Denver School of Medicine, Aurora, CO 80045, USA.

Vaginal bleeding in the first trimester occurs in about one fourth of pregnancies. About one half of those who bleed will miscarry. Guarded reassurance and watchful waiting are appropriate if fetal heart sounds are detected, if the patient is medically stable, and if there is no adnexal mass or clinical sign of intraperitoneal bleeding. Read More

Ultrasound Obstet Gynecol 2009 Apr;33(4):484-6

Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Suita City, Osaka, Japan.

Amniotic fluid 'sludge' is defined as the presence of dense aggregates of particulate matter in close proximity to the internal cervical os. It is of clinical significance in asymptomatic patients at high risk for spontaneous delivery, and in patients with preterm labor and intact membranes. Subchorionic hematoma is another ultrasound finding that is associated with a higher incidence of threatened miscarriage and preterm delivery. Read More