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Hematoma in the short term. Causes and treatment of hematoma during early pregnancy

26.09.2017

During gestation, a woman’s body undergoes many changes, and sometimes pathologies are detected. One of them is a hematoma in the uterus. There is no need to panic, the situation is not so tragic.

It is necessary to understand the mechanism of hematoma formation in order to assess the prognosis. We will talk about internal hematoma, and about bruises on the stomach left after caesarean section, you can find out from another article.

After fertilization, the egg will be formed ovum, the whole process takes place against the background of the production of estrogen and progesterone. These hormones soften the uterine endometrium and make its surface loose, this is necessary to make it easier for the zygote to grow into it. This process is mandatory for the formation amniotic membranes. Subsequently, such shells serve the embryo as protection and nutrition. At the very beginning, the fertilized egg is located in a bubble of fluid (amnion), around which there is a membrane - the chorion.

Sometimes the attachment of the fertilized egg to the uterus is not entirely tight, which is why spotting occurs during pregnancy. That is, a space is formed between the inner layer in the uterus itself and the outer membrane of the fetus. This space, thanks to active blood circulation, quickly fills with blood. Against the background of damage to the vessels connecting the 2 surfaces, blood accumulates and then comes out through the hole in the cervix. It is impossible to say exactly how long it will take for a hematoma to resolve - it all depends on the specific conditions.

Hoping that everything will go away on its own is dangerous, since the same symptoms occur in different diseases. During pregnancy, both mother and child are at risk. That’s why it’s so important to immediately go to an obstetrician-gynecologist if you feel unwell and have unclear symptoms.

Causes of hematoma formation

Factors that can provoke the formation of a hematoma are the following:

  • hormonal disbalance. Due to a deficiency or excessive amount of certain hormones, the attachment of the fertilized egg to the uterine endometrium does not occur as it should;
  • Due to the heavy physical activity of the mother, the uterus does not function well. Therefore, against the background of pathology, bed rest is often prescribed;
  • psycho-emotional shock, nervous overstrain;
  • abnormalities in the structure of the uterus and fetal development;
  • severe toxicosis;
  • injuries that provoke the release of adrenaline into the blood, which causes contraction of the muscles of the uterus and increased blood circulation;
  • various diseases of the genital organs;
  • alcohol abuse, smoking, drug use.

Types of hematoma in pregnant women

Taking into account the timing of detection of a hematoma and its development, doctors distinguish 2 types of it:

  1. Retrochorial. It usually appears between 1 and 16 weeks, when the placenta is not fully formed. The cavity is located between the uterus and chorion. Ultrasound does not detect a hematoma, since due to the low load on the vessels, the area of ​​the hematoma is small and there are no obvious symptoms;
  2. Retroplacental. Its differences are big sizes and a vivid picture of the course - pain, bleeding, spasms. In this case, the cavity with blood is located between the endometrium and the placenta. Such a cavity quickly fills with blood, and if no measures are taken, it poses a threat to the life of the pregnant woman and the fetus. Despite possible risks, and this diagnosis should not be a reason for excessive nervousness; the doctor will explain what and how to do to avoid complications.

In some pregnant women, the diagnosis is not determined until delivery - they do not have bruises, bleeding or any signs of pathology. During childbirth, when the placenta leaves, the doctor notices signs of hemorrhage on the placenta. Hypoxia in the fetus is possible, so the child is carefully examined and examined so as not to miss pathologies. The woman is warned that there may be a violation of blood circulation in the pelvis and legs, which is fraught with thrombophlebitis if severe physical exercise.

How a hematoma resolves during pregnancy directly depends on the severity of the hemorrhage in the uterus. There are 3 degrees:

  • light. More often refers to retrochorial hematoma, when there are no obvious signs, and great danger No. Rare, small amounts of bleeding may appear;
  • average. Characterized by aching pain in the lower abdomen. Sometimes the pain radiates to the lumbar region. Blood appears regularly;
  • heavy. A pregnant woman often has pain in the lower abdomen, like contractions, and bleeding is profuse. Possible dizziness, drop in blood pressure, fainting. With this course of the disease, a cesarean section is performed or the pregnancy is terminated, since this threatens the life of the mother.

Diagnosis and prognosis of hematoma

Before starting any treatment, a diagnosis must be made. The only one suitable option in this case - ultrasound. It is with its help that uterine bleeding is detected. Be sure to evaluate the details that will allow you to adjust further actions and predict exactly when the hematoma will begin to resolve. Important points:

  • how the hematoma is located in relation to the fertilized egg. It is bad if the formation of a hematoma occurs at the placenta location in the future. This can be noticed only by the 12th week of gestation;
  • hematoma volume. When more than 50 ml is detected, it means that the prognosis of the disease is unfavorable;
  • structural features of the hematoma. When a hematoma has clear contours and smooth edges, and the contents are homogeneous, then it is a fresh formation. Over time, the hematoma acquires unclear contours, its edges become uneven, and its contents are heterogeneous;
  • hematoma size. The larger the size of the hematoma compared to the size of the ovum, the higher the likelihood of miscarriage.

In approximately 90% of cases of retrochorial hematoma, myometrial tone increases. The diameter of the hematoma directly affects the course of pregnancy. Basically, the forecasts are distributed as follows:

  • small hematomas, the area of ​​which is equal to a quarter of the fetal egg. In this case, the prognosis is favorable and the pregnancy will continue;
  • large hematomas, the area of ​​which is equal to 2/3 of the fetal egg. This development of the disease leads to spontaneous abortion in 50% of cases;
  • very large hematomas, when the fertilized egg is completely separated from the uterine wall. Spontaneous abortion is likely.

Treatment of hematoma in a pregnant woman

In addition to ultrasound, a pregnant woman needs to undergo other examinations, including Doppler ultrasound. After a thorough examination, the doctor determines the severity of the disease and prescribes appropriate medical procedures. Retrochorial hematoma, detected at the very beginning, responds well to treatment and should resolve by the 3rd trimester. Pregnant women with this diagnosis need to undergo treatment in a hospital, where they will:

  • compliance with bed rest, since excessive abdominal tension increases blood circulation;
  • use of drugs to stop bleeding;
  • taking medications for spasms of the uterine muscles;
  • taking appropriate vitamins and minerals in combination;
  • improving blood circulation in the placenta, preventing hypoxia in the fetus.

Home preventive measure from hematomas in the uterus is the attention of women to their own health, especially in terms of reproduction.

To remove a blood clot from the area of ​​fetal rejection, Dicinon and other hemostatic drugs are prescribed. To reduce the tone of the uterine muscles, pregnant women are prescribed No-shpu, Magne-B6, Papaverine. The progesterone drugs Utrozhestan and Duphaston are required. Mild sedatives are recommended, which are not prohibited for pregnant women, as well as folic acid and vitamin E. To ensure that the hematoma resolves faster and the child does not develop hypoxia, you need to take Actovegin, a drug that improves the nutritional supply of the fetus.

Hematoma in pregnant women resolves in the absence of sexual relations life and subject to physical rest. You can speed up the release of a blood clot by taking an inclined position with your legs above your head. It is advisable to follow a diet that stimulates bowel function. This is necessary to avoid excessive stress.

Any measures should be discussed with your doctor, and no action should be taken without his knowledge. The key to a woman’s health is taking care of her body, getting rid of bad habits, timely treatment diseases of the genitourinary system.

It may happen that the expectant mother feels great, nothing bothers her, but when she comes for an ultrasound, she finds out that she has been diagnosed with a hematoma during pregnancy. A common person understands that a hematoma is a hemorrhage into the tissue layer that occurs as a result of an injury.

Today, doctors name other causes of this pathology.

ICD-10 code

T81.0 Bleeding and hematoma complicating the procedure, not elsewhere classified

Causes of hematoma during pregnancy

Modern obstetricians and gynecologists are increasingly faced with the problem of carrying a fetus to a woman who has been diagnosed with intrauterine hemorrhage. Quite often it develops against the background of fragile blood vessels that provide nutrition to the uterus and placenta.

The following are the main causes of hematoma during pregnancy:

  • Failure in a woman's metabolic processes.
  • Inflammatory and infectious diseases affecting the genitourinary system expectant mother.
  • Severe toxicosis, which is especially dangerous in later pregnancy.
  • Sharp jumps blood pressure. High numbers are especially dangerous.
  • Severe stressful situations.
  • The cause of a hematoma during pregnancy can also be a pathology of the development of the ovum.
  • Hormonal imbalance.
  • Problems observed with blood clotting pathological changes the walls of the blood vessels of the placenta and the entire woman’s body.
  • Alcohol and smoking abuse during the period when a woman is pregnant.
  • Congenital or acquired pathology of uterine development.

Symptoms of hematoma during pregnancy

Waiting for the birth of a child is a state of complete happiness, a time of hope and one of the enchanting moments in the life of any woman. But at the same time, this anxiety and worry about health is not yet born baby. A hematoma in the uterus during pregnancy is a difficult test for a woman expecting a child. Indeed, in its presence, the fertilized egg begins to peel off from the surface of the endometrium of the uterus, and blood gradually accumulates in this place, forming a bruise.

A hematoma in the uterus during pregnancy poses a serious danger for bearing a child, as it can provoke spontaneous miscarriage, especially in severe forms of the pathology. At mild degree a woman may not even notice the severity and learn about its existence after the successful resolution of childbirth.

Severe development of hematoma during pregnancy poses a danger not only for the baby, but also for his mother. Bleeding makes the mother feel worse general condition health, posthemorrhagic anemia develops. Due to a disruption in blood circulation, the fetus receives less oxygen, which leads to “ oxygen starvation“, and this, in turn, leads to inhibition in the child’s development, both physically and psychologically.

Hematoma in early pregnancy

For many, the word “hematoma” is directly associated with serious injury. Therefore, upon hearing such a diagnosis and not fully understanding its essence, a pregnant woman begins to get nervous. And she can be understood. After all, the hematoma is on early stages pregnancy may indicate the onset of rejection of the fertilized egg, which leads to miscarriage (termination of pregnancy). By the way, this pathology is not very rare, and a greater percentage of its manifestation occurs in the fifth to eighth week of pregnancy.

There are many reasons for this pathology: hormonal imbalance, a burdened hereditary history, sexual intercourse, severe nervous or physical stress.

But diagnosing a hematoma in the early stages of pregnancy allows, if possible, to undergo a course of treatment earlier, which will be the key to normal development fetus and favorable birth.

Quite often, the expectant mother does not even suspect the existence of an internal hematoma and for herself a complete surprise is its presence, which was discovered during the passage of the planned ultrasound examination. Symptoms of hematoma during pregnancy mainly depend on the severity and location of the pathology.

  • Mild severity. In this case, the pregnant woman feels normal, no physical manifestations of internal hemorrhage are detected. Hematoma during pregnancy is diagnosed only with the help of ultrasound or after childbirth has been completed safely naturally, as it leaves its marks on the placenta.
  • Moderate severity. In this case, the woman experiences pulling, aching painful sensations lower abdomen. Red or brownish discharge may appear from the genital tract. If you have such symptoms, you should immediately seek help from an obstetrician-gynecologist who is managing your pregnancy. Whether or not there is discharge largely determines the volume of the hematoma and its location. For pathology medium degree a heartbeat disturbance is heard in an unborn baby.
  • Hematoma during pregnancy of severe severity. The intensity of blood discharge increases, and the pain in the lower abdomen also increases. She becomes crampy. Against the background of bleeding, the expectant mother's blood pressure drops. The woman may even lose consciousness.

Any practicing doctor knows that if a retrochorial hematoma is diagnosed, this means that there is a direct threat of miscarriage.

Discharge from hematoma during pregnancy

If during the first trimester of pregnancy a woman observes light brown discharge from the vagina, but against the background of this does not feel any discomfort and deterioration in health, there is no need to show special concern, even if an ultrasound examination (which every pregnant woman undergoes routinely) reveals a hematoma during pregnancy.

Another question is if the color of the discharge is bright red. This already suggests that the bleeding does not stop. In this situation, it is urgent to take emergency measures, otherwise premature rejection of the fetus may occur and the woman will lose the child.

Forms

We are used to seeing various kinds of hemorrhages on the surface of the skin, but many did not even realize that there are also uterine hematomas that occur on the uterus during the period when a woman is carrying her baby. There is a classification of this pathology. The following types of hematomas are differentiated during pregnancy:

  • Clinic and period of development of the disease:
    • Retrochorial. This type of effusion is diagnosed in the early stages of pregnancy (up to 16 weeks) and represents a detachment of the fertilized egg from the chorion (outer embryonic membrane).
    • Retroplacental. By the 16th week of pregnancy, with normal fetal development, the placenta is already fully formed. If a hematoma occurs in the future, it will sooner due date, provokes placental abruption, which is fraught spontaneous interruption pregnancy, that is, a woman loses her unborn child.
  • According to the severity of the pathology:
    • Pathology of mild severity.
    • Average degree of manifestation of the disease.
    • Acute, severe hematoma during pregnancy.

Hematoma with easy pregnancy or moderate severity is an indication for a cesarean section, and the operation is scheduled for more early period what was the deadline natural birth.

Retrochorial hematoma during pregnancy

The chorion is the outer embryonic membrane that surrounds the embryo and is formed on initial terms gestational age, being a precursor to the placenta. This is where retrochorial hematoma during pregnancy gets its name, which is determined by its timing and location. This pathology develops as a consequence of detachment of the fertilized egg from the chorion. It is observed in the first trimester of pregnancy, before moving into the second. At the site of rejection, blood gradually begins to collect - a hematoma is formed, a clear sign of the threat of spontaneous abortion.

This pathology is accompanied by vaginal discharge of a slightly brownish tint. In this case, the woman experiences a nagging pain in the lower abdomen. If the hematoma is located on the fundus of the uterus, there may be no obvious symptoms of pathology. Then hemorrhage can only be detected using ultrasound.

When brown discharge a woman begins to worry about the fate of her pregnancy; obstetricians and gynecologists do not consider this a bad symptom. Since blood accumulates in the cavity between the membranes of the chorion and the fetus, coagulates there, taking on a brownish tint, discharge of this color, on the contrary, may indicate that blood clots are gradually beginning to come out, “resolving” the hematoma.

When you really need to sound the alarm is when the discharge is scarlet in color. This is a clear sign that the bleeding has not stopped, the hematoma continues to grow, the fertilized egg continues to exfoliate, and if emergency measures are not taken, the woman in labor may lose the child, since in such a situation a premature termination of pregnancy occurs. In this case, in order to assess the growth of hematoma during pregnancy, the doctor prescribes not only an ultrasound, but is also obliged to monitor the level of fibrinogen in the blood plasma.

Retroplacental hematoma during pregnancy

In the case when the ovum is rejected from the chorion, as a rule, this occurs in the first trimester, a retrochorial hematoma develops. If this process begins later (after 22 weeks of pregnancy), when the chorion has degenerated into the placenta, the same process of embryo rejection is called retroplacental hematoma. It follows the same scenario as in the first case, when the appearance of bleeding is a real threat of termination of pregnancy.

Likewise, retroplacental hematoma during pregnancy is the main symptom indicating a threat of miscarriage. The clinic of this pathology: a nagging pain in the lower abdomen, bloody discharge, increased tone uterus... The behavior of the fetus itself changes: its physical activity, negative changes occur in the heart rhythm (tachycardia is initially heard, and then bradycardia), which indicates a disruption in its normal development. The obstetrician-gynecologist interprets these signs as untimely rejection of placental tissue, which can lead to miscarriage.

In this case, early diagnosis of retroplacental hematoma during pregnancy is helped by ultrasound, which makes it possible to take timely and adequate measures to save the fetus, and the woman in labor herself.

Subchorionic hematoma during pregnancy

The most common subchorionic hematoma occurs during pregnancy. This is a fairly dangerous type of hemorrhage. He requires immediate contact with his doctor. In case of differentiation of this pathology, the size of the hematoma must be observed over time.

Retroamniotic hematoma during pregnancy

Retroamniotic hematoma during pregnancy is diagnosed at the first ultrasound examination (approximately 12 weeks of pregnancy), often without any bloody discharge is no different, but still, to be on the safe side, the obstetrician-gynecologist observing the pregnancy can admit the expectant mother to the obstetrics-gynecology department in order to observe the growth of the hematoma in the process.

Subamniotic hematoma during pregnancy

It does not pose a danger to the normal development of the unborn child. In the future, the hematoma, especially if its location is the uterine pharynx, can resolve on its own or come out in the form of clots.

Intrauterine hematoma during pregnancy

This is enough serious pathology. External or internal reasons lead to detachment of the ovum, which provokes bleeding, and then a hematoma forms at the site of rejection. If the area of ​​hemorrhage does not increase, and the pregnant woman feels satisfactorily, the embryo develops normally - then there should be no reason for concern. If the obstetrician-gynecologist sees the progression of the pathology, the question of hospitalization of the woman in labor and her treatment is raised.

Complications and consequences

The birth of a new person is the greatest sacrament that nature has given to man. But how much does the expectant mother have to worry about until the moment her baby is born? Hemorrhages of various localizations. How dangerous are they? What are the consequences of a hematoma during pregnancy? Naturally, complications may manifest themselves, or maybe everything will go well. Much in this problem depends on the parameters of the hematoma. The most dangerous is a hematoma, which occupies at least 40% of the total area of ​​the embryo membrane and whose volume exceeds 20 ml. Such a hematoma can inhibit the growth and full development of the fetus, and cause spontaneous abortion. Inhibition in the growth of the CTP (coccygeal-parietal size) for more than ten days indicates an increased risk of an unfavorable outcome of bearing a child.

The most dangerous consequence of this course of events may be “Kuveler’s uterus.” Premature placental abruption leads to the fact that the endometrium is filled with blood, foci of necrosis appear in it, which is already an indication for complete resection of the uterus. And this is already a sentence - a woman will never be able to become a mother.

Also, with a hematoma during pregnancy, there is a high probability of heavy bleeding, the consequences of which are quite difficult to predict, since it can even lead to death, both for the child and for the woman in labor.

But if the pregnant woman passed in a timely manner effective treatment, the chances of giving birth on your own and on time are normal developed baby increase sharply.

Why is a hematoma dangerous during pregnancy?

The first question asked by a woman after (after undergoing an ultrasound) she heard this diagnosis: “Why is a hematoma dangerous during pregnancy?” In many ways, the answer to this question depends on the size of the hematoma, the timing of its manifestation and its location. If a hematoma is diagnosed in the first trimester of pregnancy, this is fraught with spontaneous abortion. If the pathology occurs at a later date, the consequences of its appearance may affect the development of the fetus (lag in physical development, hypoxia (insufficient for full development baby amount of oxygen)).

The most dangerous in this category are effusions measuring 20 ml or more, which is about 40% of the volume of the ovum. In addition to inhibition in the development of the fetus itself, the risk of further placental abruption increases. If KTR ( coccyx-parietal size) the embryo is delayed in growth by more than ten days - this is bad sign, which indicates a high probability of unfavorable pregnancy resolution. Although with adequate therapy the fetus continues to develop normally, in this case a cesarean section is indicated.

Diagnosis of hematoma during pregnancy

It is advisable to diagnose any pathology in the early stages of its manifestation, when cardinal negative changes have not yet occurred, which can no longer be corrected. Therefore, in order for the pregnancy to end with a normal birth, a hematoma is diagnosed during pregnancy.

The main source of information during this period is ultrasound examination (ultrasound) - this is a modern, fairly informative research method. In addition, the obstetrician-gynecologist prescribes another examination.

  • Clinical detailed blood test
  • General analysis urine.
  • A blood test is carried out for RW and HIV.
  • Coagulogram. Determination of the prothrombin index (PTI), which shows how well the blood clots, as well as activated partial thromboplastin time (aPTT).
  • A smear for microflora, which is taken from the vagina.
  • Blood chemistry.
  • Screening for various sexually transmitted infections (STIs).
  • Doppler ultrasound (one of the types of ultrasound, used to assess the nature and speed of blood flow in the vessels, in in this case in the baby and in the placenta).
  • If necessary, a blood test for hormones is prescribed.

Hematoma during pregnancy on ultrasound

Hemorrhage during the period of bearing a baby appears when, by coincidence, the fertilized egg begins to tear away from its attached site. This leads to the development of bleeding. This pathology is observed quite often during this period and, based on the severity, can cause a miscarriage. A hematoma during pregnancy is recognized quite easily by ultrasound - this is one of the most accurate and informative methods for determining it. The presence of hemorrhage in the uterus is indicated by:

  • Increasing the thickness of one of the walls.
  • Changing the parameters of the fertilized egg.
  • The presence of a blood clot in the chorion-uterus gap.
  • Deformation of the uterine contour.

Treatment of hematoma during pregnancy

When diagnosing uterine hemorrhage, the expectant mother is prescribed bed rest (physical and emotional rest). At the same time, the treatment of hematoma during pregnancy includes not only medication, but also adjustments to the pregnant woman’s diet. Foods that stimulate increased intestinal motility are excluded from the diet.

To stop or prevent bleeding, the attending physician, if necessary, may prescribe drugs such as vikasol, dicinone, vitamin C.

Vikasol. This medicine is administered by injection into the muscle for three to four days with a four-day break. The daily dosage is 1-1.5 mg, divided into two to three injections. The maximum daily dose is 30 mg, single dose is 15 mg. If necessary, after a break the course of treatment is repeated.

It has this drug And side effects: the appearance of spasms in the bronchi, thromboembolism (acute blockage of a blood vessel with a thrombus), rash and itching of the skin, hemolytic anemia (increased destruction of red blood cells), urticaria, as well as erythema (redness of the skin).

Dicynone. To prevent bleeding, the doctor usually prescribes one or two ampoules of the drug, which are injected into a muscle or vein, then after four to six hours the woman is given one ampoule or two tablets of the drug are taken.

Summons Dicinon and side effects, which include: pain in the head, heaviness in the stomach, heartburn, decreased blood pressure, paresthesia of the lower extremities, facial flushing.

Contraindications for Dicinon:

  • Vascular thromboembolism.
  • Vein thrombosis.
  • Hemorrhage.
  • Individual intolerance to the components of the drug.

Vitamin C. The vitamin tablet is taken orally, chewed, with a small amount of water immediately after meals. The daily dosage is 250 mg. Course duration is 10 – 15 days. If necessary, the dosage can be doubled.

Typically, ascorbic acid is quite well tolerated, but there are exceptions when side effects begin to appear: diarrhea, diarrhea, nausea and vomiting, stimulation of the central nervous system, formation of kidney stones, allergic reaction for the drug.

There are also contraindications: thrombophlebitis, predisposition to thrombosis, hypersensitivity to ascorbic acid.

Treatment of uterine hematoma during pregnancy

If hemorrhage is diagnosed in the early stages, treatment of uterine hematoma during pregnancy is carried out using the most popular medications such as papaverine and no-shpa.

But if the hematoma occupies a small area, then treatment may not be given; the attending physician will only closely monitor its parameters and, if it grows, will begin treatment.

Papaverine. This drug is administered both intramuscularly and intravenously at 40–60 mg three to five doses per day.

It is necessary to take this drug with caution in women prone to constipation, who have a history of individual intolerance to the components of the drug, liver failure, glaucoma and other pathologies.

There are also side effects: drowsiness, arterial hypotension, ventricular extrasystole and some other manifestations.

No-shpa. The dosage of this drug is 40-80 mg once. Reception - three times a day.

This drug is contraindicated for those patients who suffer from hypersensitivity to the components of the drug, as well as disruption of the normal functioning of the kidneys and liver, arterial hypotension, atherosclerosis of the coronary arteries, and so on.

There are also side effects:

  • Increased heart rate.
  • Increased functioning of the sweat glands.
  • Dizziness.
  • Fall in blood pressure.
  • Skin rashes of an allergic nature.
  • And others.

To stop bleeding, the doctor prescribes hemostatic medications (vicasol, ascorutin, dicinone), they will not allow the hematoma to progress during pregnancy.

Askorutin. This medicine is taken one tablet three times a day. The course of treatment is as necessary, but about three to four weeks. This drug is contraindicated for use in patients with increased sensitivity to the components of the medicine, as well as for gout, diabetes mellitus, thrombophlebitis and some other pathologies.

To remove stressful state, good to drink valerian tablets or drops, and tea with lemon balm leaves.

It’s a good idea to take B vitamins in this situation:

  • Vitamin B1 or thiamine. Promotes the process of energy formation from fats, proteins, carbohydrates. Its deficiency can be compensated for by foods such as liver, pork and beef, spinach, yeast, grains, and nuts.
  • Vitamin B2 or riboflavin. It is extremely important for maintaining vision, normal functioning of human skin and mucous membranes, as well as for the synthesis of hemoglobin. Asparagus, dairy products, eggs, meat, fish are very rich in it.
  • Vitamin B3 or nicotinic acid (niacin). Promotes detoxification. Contained in such products as: liver, veal and chicken meat, kidneys, heart, milk and others.
  • Vitamin B6 or pyridoxine. This vitamin is involved in carbohydrate metabolism, hemoglobin synthesis, and so on. Found in large quantities in beans, rice bran, yeast, wheat germ...
  • Vitamin B12 or cyanocobalamin. Takes part in the formation of red blood cells, has a positive effect on nervous system. Contained in seafood, liver, dairy products.

A woman with a hematoma during pregnancy should not introduce into her diet foods that have obvious strengthening and laxative properties. During this period, you should not abuse carbonated drinks, drink coffee and very strong tea, as well as dietary supplements.

To support immune system pregnant women are prescribed gestagens.

Duphaston. In case of threat of miscarriage, the drug is administered orally in a single dose of 40 mg. Subsequently, every eight hours the patient receives 10 mg of the drug until symptoms completely disappear. To date, there is no data on contraindications for the drug in question, except for individual intolerance to its components.

Utrozhestan. When there is a threat of miscarriage, a capsule of this medicine is inserted into the vagina. Daily dose is 200-400 mg, taken in the morning and evening (I and II trimesters of pregnancy).

Contraindicated this medicine people with hypersensitivity to its components, with thrombophlebitis, thromboembolism, bleeding of unknown etiology, and so on.

Also attributed tocolytic drugs, helping to relieve uterine spasms.

Magnesium sulfate. The drug is administered intramuscularly in 20% or 25% solutions. The concentration and dosage are prescribed by the attending gynecologist individually. The prescribed dosage varies between 5 -20 ml.

Treatment of retrochorial hematoma during pregnancy

A retrochorial hematoma is formed when the fertilized egg is rejected from the chorion, the precursor of the placenta. This pathology is diagnosed quite often and, with an adequate approach and timely therapy, does not lead to irreversible consequences. Treatment of retrochorial hematoma during pregnancy is carried out only in a hospital setting under the constant supervision of an obstetrician-gynecologist.

During this period, the expectant mother needs to reduce physical activity, rest more, and if there are medical indications, bed rest is prescribed. The diet should be balanced and complete.

Treatment of retrochorial hematoma during pregnancy includes not only adjustments to diet and lifestyle, but also drug therapy. During this period, a woman is prescribed hemostatic agents. medical supplies(vicasol, dicinone, ascorutin). To relieve pain and relieve spasms, a pregnant woman should take antispasmodics (paraverine, no-shpu). Vitamins are also prescribed mineral complex, ready to support the body of the expectant mother. And also vitamin E (tocopherol) - an antioxidant designed to protect cells from the influence of pathogenic flora; And folic acid– a vitamin enzyme necessary for the growth and development of the circulatory and immune systems.

For more intense blood outflow from the female genital area, the woman needs to lie so that the pelvis is slightly elevated. This can be easily achieved by placing a folded blanket or pillow under your butt. During this period, it is recommended to stop any sexual relations.

To relieve uterine spasms and relax muscles, pregnant women are prescribed Magne B6, which is taken two tablets two to three times a day. Take the drug with plenty of water. Contraindications to this medicine include pathology of the kidneys and hypersensitivity to the components. Side effects have also been identified: peripheral neuropathy, diarrhea, numbness in the limbs, pain in the abdomen.

To improve the quality of fetal nutrition and prevent the development of hypoxia, the doctor prescribes Actovegin and chimes.

Actovegin. To prevent normal blood circulation and metabolic processes in the brain of both the mother and her child, a starting dose of the drug is administered intravenously - 10 ml daily for two weeks. In the future, if there is medical indications, this dose is adjusted - 5 - 10 ml several times a week (as prescribed by a doctor) for a month. You should not use this drug if you have anuria (complete cessation of urine flow from the kidneys to the bladder), pulmonary edema, heart failure, as well as individual intolerance to the components of the drug.

Chimes. The drug is prescribed at a rate of 75 to 225 mg per day, divided into three to six doses. Subsequently, the dose of the drug can be reduced to 25-50 mg. Only for acute manifestations of pathology, the daily dosage can be 600 mg.

The drug in question is contraindicated for people suffering from intolerance to any of the constituent substances, as well as for diseases such as collapse, myocardial infarction, bleeding of unknown etiology and others.

Advice to women who have been diagnosed with retrochorial hematoma during pregnancy should not neglect the recommendations of the treating doctor, since such a pathology is a fairly serious condition.

Tranexam for hematoma during pregnancy

In case of bleeding or its threat, obstetricians and gynecologists quite often prescribe a hemostatic drug, which is an inhibitor of fibrinolysis. Well established Tranexam

If the disorder is recognized early and the volume of the hematoma does not exceed 20 ml, and adequate and timely treatment is carried out, there is no threat of termination of pregnancy in the future. In rare cases, when the pathology takes over large areas rejection and is accompanied by heavy bleeding, there is a real threat to the life of the pregnant woman. In this case, the question of emergency termination of pregnancy is raised. If treatment was not carried out (but was indicated), then the prognosis of a hematoma during pregnancy is unfavorable - there is a high probability of developing a spontaneous miscarriage, while timely treatment leads to a normal birth and the birth of a healthy baby.

We can conclude that hematoma during pregnancy is a frequently diagnosed pathology that occurs at various stages of fetal development. The symptoms also depend on this. If a pregnant woman is diagnosed with this, there is no need to panic, but you should not neglect the doctor’s advice. After all careful attitude taking care of yourself and your health will help not only save your life, but also give birth to a healthy, strong baby.

11.09.2017

Pregnancy is best period in the life of every woman. But the joy of bearing a child is overshadowed by the appearance of problems, including uterine hematoma.

Some women, when they heard on an ultrasound about a hematoma in the uterus, begin to panic and begin to worry about the health and well-being of the baby.

During pregnancy, a woman's uterus becomes vulnerable. Its size increases, the walls thicken, and the uterus may be subject to hemorrhage.

A hematoma in the uterus during pregnancy is an accumulation of blood in a damaged area of ​​an organ or tissue, which causes the formation of a small vacuole filled with either fluid or blood. This phenomenon during pregnancy can present serious threat for the child and mother, because the resulting tumor can provoke separation of the fertilized egg and, as a result, the pregnancy can be terminated.

If a woman, while pregnant, notices any deterioration in her health, then she needs to consult a doctor. Timely diagnosis and effective treatment can prevent the development of serious consequences.

Causes of uterine hematoma during pregnancy

Anyone who hears the word hematoma imagines a bruise on the skin or organ that appears as a result of an injury.

A uterine hematoma usually appears in the early stages of pregnancy and means the separation of the fertilized egg from the chorion, as a result of which a cavity with blood forms in the uterus. Some time ago, the only cause of this pathology was considered to be excessive physical activity or injuries to the abdomen and genitals.

Detachment of the fertilized egg from the chorion

But medicine has revealed that the phenomenon can occur as a result of factors:

  • hormonal imbalance;
  • stay in stressful situations, frequent excitement;
  • diseases of the genitourinary system of an infectious nature;
  • gynecological diseases;
  • pathologies of embryo development;
  • severe toxicosis;
  • sudden jumps in blood pressure;
  • smoking, drinking alcohol or using drugs;
  • bleeding disorders;
  • physical or nervous stress;
  • abdominal injuries;
  • completed sexual intercourse;
  • multiple pregnancy.

Weakness of the blood vessels of the placenta and uterus can lead to the development of a tumor in the uterus. Such changes in blood vessels can occur as a result of impaired metabolism. These reasons and some others can provoke hemorrhage during pregnancy. Typically, uterine hematoma is detected in patients in the second month of pregnancy, and the presence of this problem can only be determined using ultrasound. Sometimes hematomas occur on the uterus after a caesarean section.

Classification of uterine hematomas

As mentioned earlier, a hematoma in the uterus during early pregnancy, which many are accustomed to considering as a consequence of injury, occurs for other reasons. Typically, the cause of a hematoma is detachment of the ovum, which leads to the accumulation of excess blood. There are types of uterine hematomas during pregnancy:

  • retrochorial. This type of hematoma occurs during early pregnancy, since the chorion is the embryonic part of the placenta, which functions only in the first trimester of pregnancy. After this time, the chorion turns into the placenta. But it is in the first 3-4 weeks that the ovum detaches. And if you go to the hospital in time, you can prevent termination of pregnancy;
  • retroplacental hematoma. It develops later, after the 15th week of pregnancy, when the placenta is fully formed. This type of hematoma can lead to spontaneous miscarriage. If the pathology was noticed in a timely manner, then the fetus can be saved with the help of hemostatic therapy;

Retroplacental hematoma is considered a very dangerous and terrible disease.

  • retroamniotic. It develops as a result of hemorrhage between the uterine wall and the amniotic membrane. This phenomenon poses a danger to the woman and fetus only in case of bleeding;
  • intrauterine. This hematoma poses a serious threat to the life of the mother and child and is accompanied by partial or complete rupture of the uterus;
  • subamniotic. It does not pose any danger to the fetus; the hematoma resolves on its own and is removed.

Retroplacental hematoma is a dangerous and insidious phenomenon, as it is not always accompanied by bleeding. And in many cases, the woman simply feels a little unwell and aching painful sensations in the uterus. In this case, saving the fetus is possible only if you consult a doctor in a timely manner.

Symptoms of hematoma in the uterus during pregnancy

Expressiveness clinical picture with a hematoma in the uterus depends on the location and size of the blood clot. A small hemorrhage may not manifest itself in any way and may not have any effect. negative influence on expectant mother and a child. The most important sign of a hematoma in the uterus is bloody vaginal discharge during pregnancy.

The greatest danger is represented by bright red discharge, which means unstoppable intrauterine bleeding. All symptoms of hemorrhage in the uterus are divided into several forms depending on the severity:

  • Light form. This is an asymptomatic stage of the disease, so hematoma can only be detected using ultrasound. Although it often happens that it is discovered only after a cesarean section or natural birth. The expectant mother does not feel any changes and can only occasionally complain of slight discomfort. Pregnancy in this case proceeds normally, childbirth takes place naturally, but with the help of amniotomy, that is, artificial opening of the fetal bladder.
  • Medium shape. Hematoma moderate severity brings obvious discomfort to the woman. The expectant mother begins to complain of constant nagging pain in the lower abdomen and brown discharge from the uterus is observed. These signs usually worry a woman, so the doctor sends her for an ultrasound to identify the size and location of the hematoma, as well as possible consequences for the fetus. This phenomenon usually poses a danger to the life of the embryo, so immediate medical intervention is required. The birth takes place by caesarean section.
  • Severe form. This is the most dangerous form hematoma, which poses a serious threat to the life of the child and mother. The woman’s health deteriorates significantly and she begins to feel uneasy severe pain lower abdomen, bleeding from the genital tract and decreased blood pressure, even to the point of fainting. In the first weeks of pregnancy, such a hematoma leads to spontaneous miscarriage.

A woman is bothered by brown or yellow discharge from the vagina, which mean the organization of uterine hematoma during pregnancy. The hematoma resolves and may come out of the uterus as dark clots of dried blood.

The health of the mother and child is not in danger. But the woman complains only of discomfort and deterioration in well-being. Sometimes there may be difficulties with diagnosis and initiation of treatment.

Diagnosis and treatment of uterine hematoma

The woman tells the doctor about the symptoms that bother her, and the specialist sends her for an ultrasound examination. It is necessary to conduct diagnostic studies:

  • blood and urine tests;
  • coagulogram;
  • vaginal smear;
  • analysis for sexually transmitted infections;
  • Dopplerometry;
  • hormone analysis.

After detecting a hematoma, the doctor prescribes treatment, which depends on the stage of pregnancy and the size of the tumor. Complex therapy the first step is to prevent further expansion of the hematoma. If the hemorrhage is small, the hematoma resolves without the use of specific therapy. Treatment of hematoma in the uterus during pregnancy consists of the following:

  • staying in bed;
  • a complete diet;
  • taking medications to stop bleeding: Dicynon, Vikasol;
  • prevention of uterine tone with the help of antispasmodics: Papaverine, No-shpa;
  • normalization of hormonal levels with gestagens: Utrozhestan, Duphaston;
  • prevention of fetal hypoxia with the help of anticoagulants: Clexane, Curantil;
  • resorption of the hematoma using the homeopathic drug Wobenzym.

An important point is the absence of anxiety and stress during pregnancy. For this purpose, the doctor may prescribe sedatives, as well as vitamin and mineral complexes.

During pregnancy, women are registered with an obstetrician-gynecologist and undergo several screenings aimed at identifying intrauterine pathology in the fetus. The first is carried out at 12 weeks, but even before that there may be warning signs pathology in the form bloody discharge. This is how a hematoma occurs during pregnancy, which can become a threat to its termination. Symptoms are similar to other pathological and dangerous violations, so a diagnosis of the condition is necessary.

Causes

- accumulation of blood between the chorionic sac and the endometrium (retrochorionic). Formed due to damage to soft tissues due to partial detachment of the fertilized egg. It is a complication of pregnancy that threatens the fetus and the health of the mother.

Causes of hematoma formation:

  • hormonal changes in a woman’s body, in particular the development of diabetes;
  • severe toxicosis of the first trimester;
  • infectious and chronic inflammatory diseases of the pelvic organs;
  • vascular changes;
  • long-term and chronic stress;
  • arterial hypertension;
  • thrombophilia;
  • rough sexual intercourse.

Many external and internal factors can lead to a hematoma, so when a woman is pregnant, she should follow a gentle regimen and avoid risk factors. Doctors are rarely able to determine the right reason complications. The multifactorial development of a hematoma cannot be ruled out, when several reasons serve as the reason for its formation.

Symptoms

There are no characteristic symptoms confirming that a retrochorial hematoma emerges during pregnancy. The condition is similar to uterine bleeding, menstruation. Clinical manifestations largely depend on the severity of the pathological process. The severity of the condition can be reliably determined only when ultrasound diagnostics. Symptoms of hemorrhage in the uterus can be mild or intense, but even slight suspicions of pathology are a reason to seek qualified medical help.

With a hematoma, you may notice the following symptoms:

  • nagging pain in the lower abdomen;
  • discomfort in the pelvic area;
  • periodic sharp and cramping pain in the suprapubic region;
  • temperature increase;
  • bloody, red or brown discharge (depending on how old it is and the presence of bleeding vessels at the site of amniotic sac detachment).

Vaginal discharge appears when the hematoma is emptied, when blood begins to gradually come out. A sign of improvement in the condition is precisely the appearance of dark discharge, while the presence of scarlet blood indicates an increase in the area of ​​detachment. All these processes can be detected using ultrasound.

A hematoma during pregnancy may resemble the symptoms of menopause. Often occurs in women after 45 years of age, when pregnancy becomes unplanned, and its symptoms, including pregnancy, are perceived as manifestations of premenopause. Brown spotting, weakness, drowsiness, mood swings, nausea, discomfort and pain in the pelvic area should not be left unchecked by a specialist.

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Retrochorial hematoma appears in the early stages of pregnancy - about 5-8 weeks of embryogenesis. There are 3 forms:

  • light;
  • average;
  • heavy.

At mild form the hematoma may resolve on its own or come out during the day in the form of brown discharge (the woman sees coagulated blood). Also, the discharge may be spotting and observed for about 2 weeks in small portions. If discharge accompanies pregnancy for a long time, but there are no other symptoms, then you should seek medical help.

At average shape nagging pain appears in the lower abdomen and the amount of discharge will be significantly greater than with a mild degree. Sometimes you can even confuse the release of a hematoma with menstruation, given the presence nagging pain in the lower abdomen, which can be dangerous in an undiagnosed pregnancy. Here the release time is longer - up to 5 weeks. The pain is intense, so women often take painkillers or antispasmodics, often without a doctor’s prescription, which is fraught with the development of complications for both mother and child.


In severe form, if the hematoma has left the uterus, but abundant scarlet discharge, meaning bleeding, you need to urgently seek medical help. General weakness, malaise, and dizziness may appear due to the sudden loss large quantity blood. The condition is urgent and requires hospitalization under medical supervision.

What to do

Uncontrolled use of medications can increase the risk of miscarriage, leading to complications for the mother's body. Do not despair, since emotional peace is an integral part of the treatment of retrochorial hematoma. You cannot take measures on your own at home, regardless of the severity of symptoms and other factors, you need to consult your doctor.

At the appointment, the gynecologist will use an ultrasound machine to determine the size of the hematoma and prescribe the appropriate treatment. There is no treatment algorithm for mild forms. The scope of assistance comes down to observation, prescription of general strengthening drugs - multivitamins, ascorbic acid, vitamins E and group B.


In the moderate form, treatment will be carried out in a hospital, often day stay. The woman is examined, tests are performed, and special treatment is prescribed. drug treatment. Observation continues until complete cessation symptoms and release of hematoma.

In severe cases, emergency hospitalization will be required. Uterine bleeding is an indication for surgical treatment of hematoma. It is possible to terminate a pregnancy in order to save the woman’s life. Self-medication with drugs and folk remedies is contraindicated in this situation - there is a high risk of developing complications, often incompatible with life.

  • gentle regime of work and rest;
  • inclusion of cereals, fruits, vegetables in the diet;
  • avoidance of products that cause gas formation;
  • abstinence from sexual intercourse;
  • psycho-emotional peace.

If a woman finds it difficult to control her emotions, then sedative teas based on mint and chamomile, as well as Valerian tablets, are prescribed.

Consequences

The consequences depend on the condition of the mother’s body and her timely actions - identifying symptoms, contacting a gynecologist and starting treatment in a hospital. Directly depend on the severity and shape of the hematoma. In mild forms, it resolves or comes out completely quickly. Having seen the discharge, the woman goes to the doctor, but the ultrasound shows no complications - the danger to termination of pregnancy and the life of the mother has receded.

In moderate and severe forms, the following complications may occur:

  • uterine bleeding;
  • termination of pregnancy (miscarriage);
  • pelvic inflammation - infection with secondary infections in the presence of chronic lesions.

In order to prevent the development of complications and adverse consequences, it is recommended to undergo re-diagnosis after treatment.

Not every woman can avoid health problems during pregnancy. Most often these complications are minor, but sometimes they can be quite dangerous. A hematoma in the uterus during pregnancy means that in a separate area there has been a detachment of the chorion of the fetal egg or placenta with damage to the vessels and tissues of the organ, as a result of which a space containing liquid or coagulated blood is formed.

A hematoma in the uterine cavity that occurs during pregnancy can be dangerous for the expectant mother and child. Timely diagnosis and treatment most often provide positive result- the pregnancy can be maintained.

A hematoma in the uterus discovered during pregnancy is a serious complication.

There are two types of hematomas:

  • Retrochorial hematoma in the uterus can appear in early pregnancy - up to 16 weeks. The reason is that a partial detachment from the chorion has occurred between the fertilized egg and the uterus, resulting in the formation of a hematoma.
  • Retroplacental hematoma in the uterus is diagnosed from the 16th week, when the fertilized egg begins to peel off, most often this happens when a woman is waiting.

Usually, we're talking about about retrochorial hematoma that occurred in the uterus during pregnancy. Why does pathology develop?

Experts cite the following factors:

  • imbalance of hormones in the body;
  • infectious and inflammatory diseases of the genitourinary system;
  • gynecological diseases of women, for example, etc.;
  • severe form;
  • malformations of the uterus;
  • deep stress factors;
  • autoimmune diseases caused by blood clotting disorders;
  • problems with the fertilized egg, for example, defects in its development;
  • various injuries;
  • bad habits.

Kinds

Retrochorial hematoma is most often diagnosed in expectant mothers. Pathology occurs as a result partial detachment fertilized egg from the uterine wall.

Symptoms of retrochorial hematoma are:

  • abdominal pain;
  • yellow discharge, and then spotting.

The process of detachment of the ovum leads to trauma blood vessels. As a result, spaces filled with small hemorrhages appear at the sites of rejection. This is a uterine hematoma or bruise, the causes of which can be very different.

Most often, the fertilized egg exfoliates in pregnant women over 35 years of age. This can also happen if a woman is carrying twins or. Regardless of the cause of the hematoma formed in the uterus during pregnancy, the patient needs timely diagnosis and treatment that will help avoid termination of pregnancy.

Retroplacental hematoma is usually diagnosed from the 16th week of pregnancy, after the placenta has fully formed. This condition is dangerous. The situation is insidious in that a retroplacental hematoma does not always cause bleeding. Usually a woman complains of deterioration of well-being and pain in the uterine area. The chances of maintaining a pregnancy are small, but there is a chance if a woman consults a doctor in a timely manner.

Forms

The following forms of pathology are distinguished depending on the severity.

Easy to form

It can be asymptomatic, that is, the expectant mother does not notice any changes in well-being, sometimes there are complaints of minor discomfort. In this case, a uterine hematoma can often be detected only after childbirth, if it is not previously detected by ultrasound. In any case, pregnancy usually proceeds normally.

Childbirth with a slight hematoma on the uterine wall in most cases is carried out without any complications, but with the use of amniotomy - artificial opening of the amniotic sac.

Medium form

With a moderate uterine hematoma, a woman will be bothered by severe and periodic uterine bleeding Brown. Of course, such clinical manifestations of a hematoma do not go unnoticed; when visiting a doctor, the diagnosis is confirmed using ultrasound, the size of the pathology is determined, possible complications for the fetus.

A hematoma in the uterus in this form rarely causes consequences in the form of massive bleeding - much depends on the size of the pathology and where it formed. This condition is dangerous for the unborn child, as it has bad influence on metabolic processes in his body, interferes with blood supply, affects the functioning of the heart, and provokes the development of developmental anomalies. Therefore, urgent medical intervention is necessary.

Severe form

This form of hematoma during pregnancy is the most dangerous for mother and child. The woman’s well-being suffers: cramping pain, bleeding from the genital tract, decreased blood pressure and even fainting. In the early stages of pregnancy, for example, at 5 weeks, such a hematoma in the uterus usually ends spontaneously.

Symptoms

Degree clinical manifestations for uterine hematoma completely depends on its size and location. Minor hemorrhages may not affect the course of pregnancy or the woman’s well-being at all.

The danger is represented by bright scarlet discharge, which indicates an ongoing uterine bleeding. They represent real threat termination of pregnancy, so the woman requires emergency care.

Discharges of yellow, brown and brown color with a uterine hematoma are less dangerous. There is such a term as a hematoma at the stage of organization during pregnancy - in this case, it resolves in the uterus, which leads to brownish discharge. This condition means that nothing threatens the pregnancy, but only the attending physician can confirm or refute this assumption. This is exactly how a hematoma comes out of the uterus during pregnancy - dark clots of dried blood.

In addition to discharge from the genital tract, a woman may complain of pain in the lower abdomen. They do not pose a danger if we are talking about a hematoma that comes out of the uterus.

Diagnostics

It is important to identify any pathologies that develop during pregnancy. early stage to avoid irreversible consequences. To avoid complications, it is necessary to find out why a hematoma forms in the uterus during pregnancy.

The main diagnostic method is ultrasound.

But in addition to ultrasound, a hematoma in the uterus during pregnancy requires additional research:

  • general and biochemical tests blood;
  • analysis for sexually transmitted infections (STDs);
  • blood test for hormones.

Treatment

How to treat retrochorial hematoma in the uterus during pregnancy? The main task is to prevent its further growth. For this purpose, a woman can be prescribed hemostatic drugs - Dicynon, Vikasol,.

It is also necessary to eliminate it, since it often causes miscarriage. For this purpose, antispasmodics, Papaverine, Magnesium sulfate are prescribed. They help relieve cramping pain and tension in the uterus.

To normalize hormonal background patients are prescribed gestagens. It could be - drugs that normalize the functions of the endometrial mucosa, which is necessary for uterine hematoma. Duphaston is prescribed from the early stages of pregnancy, for example, from the 5th week, for a long period, usually up to the 16th week, but sometimes women are forced to take it until the very birth. An analogue of Duphaston is Utrozhestan.

To improve the quality of fetal nutrition and prevent it, the doctor prescribes anticoagulants, for example, Curantil,. Such drugs have an antithrombotic effect, promote blood thinning and are a derivative of low molecular weight heparin.

Wobenzym is prescribed to resolve hematomas in the uterus. This is a homeopathic drug that has immunomodulatory, fibrinolytic, antiplatelet and anti-edematous effects, which allows it to be widely used in gynecological practice.

We also need to remember about psycho-emotional state future mother. Therefore, in addition to the treatment regimen, the doctor prescribes drugs that calm the nervous system and help relax the uterus, for example.

During treatment according to the drawn up scheme, the woman should be in complete peace, both from a physical and moral point of view. should be excluded until the hematoma resolves. It is advisable to maintain bed rest throughout the entire course of treatment for a hematoma in the uterus without resorting to surgery - during pregnancy, it is recommended that the legs are slightly higher than the level of the head. Thanks to this, the bleeding stops faster.

Regardless of the stage of pregnancy, even if a hematoma in the uterus was diagnosed by ultrasound at week 5, the woman is recommended to remain in the hospital during treatment. This condition can occur at any stage (both at 5 and 15 weeks of pregnancy). Emergency surgery to remove the hematoma is necessary after confirming that it has covered most of the uterus and there is a true threat to the patient’s life.

Consequences

Any uterine hemorrhage is dangerous, especially during pregnancy. The danger of a hematoma depends on its size, which is diagnosed using ultrasound. Formations occupying more than 45% of the area of ​​the uterus and a volume of more than 15 ml lead to slower growth of the fetus, increasing the risk of rejection. Only timely health care can save pregnancy and allow the fetus to develop further normally.

The most dangerous complication of bruising in the uterus is early rejection placenta or uteroplacental apoplexy. Against this background there arises profuse bleeding, which exits into the peritoneal cavity. Tissues filled with blood begin to die. To save the woman, an operation is performed to remove the uterus - amputation after complications of a hematoma. Of course, a situation in which the reproductive organ can be removed is extremely undesirable for a woman who wants to become a mother, but sometimes this is the only opportunity to save the patient’s life.

The outcome of hemorrhages is difficult to predict. A hematoma can form on the cervix, in the suture area after or after an abortion - all these conditions are considered potentially dangerous, because, first of all, a woman’s life depends on them. Therefore, it is important to be attentive to your well-being and not to lose sight of the first signs of trouble, because without them the doctor will not be able to timely diagnose a hematoma in the uterus during pregnancy.

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