In their recent retrospective cohort study, Lou et al. (2024) investigate the association between first-trimester subchorionic hematoma (SCH) and pregnancy loss before 20 weeks in singleton pregnancies. Drawing on a sample of 1,144 pregnancies from a single hospital, where 559 (48.9 %) presented with SCH, the authors found that SCH was independently associated with miscarriage risk: adjusted odds ratio (aOR) 1.94 (95 % CI 1.19–3.15) for pregnancies with SCH versus those without. Notably, an earlier diagnosis of SCH (before 7 weeks’ gestation) further elevated miscarriage risk (aOR 2.71, 95 % CI 1.45–5.07).
Interestingly, while the size of the hematoma did **not** correlate with miscarriage risk, the authors did observe that larger SCHs were linked to increased risk of placental abruption (aOR 5.03, 95 % CI 1.20–21.11). Additionally, the use of the progestogen dydrogesterone appeared to confer a protective effect (aOR 0.28, 95 % CI 0.15–0.52) in women with SCH.
The study contributes importantly to the literature by using a general obstetric population rather than focusing solely on high-risk subgroups (e.g., IVF patients), and by incorporating medication treatment as a variable. The authors acknowledge limitations including single-centre design and retrospective nature but suggest that the presence of SCH should prompt careful counselling, monitoring and possibly therapeutic consideration.
In sum, this research underscores that the detection of a first-trimester SCH in singleton pregnancies is not a benign finding and should be regarded as a serious risk factor for early pregnancy loss, thereby meriting attention in prenatal care protocols.
Reference:
- Lou, Y., Chen, G., Wang, L. et al. Association between first-trimester subchorionic hematoma and pregnancy loss before 20 weeks of gestation in singleton pregnancies. Sci Rep 14, 30034 (2024). https://doi.org/10.1038/s41598-024-817593
Serra Húnter Fellow of Sociology at Universitat Rovira i Virgili.
Former DAAD-Gastprofessorin at Julius-Maximilians-Universität Würzburg