Ībruptio placentae is one of the most serious complications of pregnancy, accounting for up to 25% of perinatal deaths. The percentage of placental detachment is the prognostic factor most strongly associated with fetal mortality: the frequency of fetal demise is 50% for retroplacental hematoma versus 7% for marginal subchorionic hematoma. In general, small- and moderate-sized subchorionic hematomas have a better outcome than large ones. This appearance may mimic hematoma but is caused by retroplacental veins.Ĭorrelation between the size of the subchorionic hematoma and the rate of pregnancy loss is imperfect. Slow-moving particles were seen on real-time imaging. Transverse sonogram of placenta reveals hypoechoic structures ( arrows) behind and at edge of placenta. Retroplacental veins mimicking hematoma at 36 weeks' gestational age. Occasionally, prominent basal veins may mimic subacute hemorrhage ( Fig. 4 ) should be distinguished from chorioamniotic separation. Subchorionic bleeding dissecting around the endometrial cavity ( Fig. A marginal subchorionic hematoma can mimic a twin gestational sac ( Fig. Most hematomas gradually decrease in size on follow-up. Depending on the time elapsed since the bleeding, the collection will have variable echotexture it will be hyperechoic initially, with decreasing echotexture over time. Subchorionic hematomas manifest as crescentic collections lifting the chorionic membrane (Figs. 2A ) when small, this collection is physiologic. In early pregnancy, a hypoechoic collection is often seen adjacent to the gestational sac ( Fig. Subamniotic hemorrhage is contained within amnion and chorion and thus extends anteriorly to placenta but is limited by reflection of amnion on placental insertion site of umbilical cord. P = placenta, red = hematoma, blue line = amnion, pink line = chorion. Drawings show classification of hematomas in and around placenta.
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