For any woman, pregnancy is the main event that the majority of the fair sex strives for, starting from childhood. The joy of the upcoming event in a few months is simply impossible to describe. However, there are some problems that can overshadow her. One of them is a retrochorial hematoma.
Unfortunately, in our time it rarely happens that the bearing of a child proceeds completely without stressful situations. And as many knowledgeable people advise, it is better to immediately consult a doctor if there are disturbing signs of any nature. Let it be better mere trifles, but the only way to control the whole process and protect not only yourself, but also your child.
What is this pathology and what are the main causes of its appearance?
General information
During pregnancy, a hormonal restructuring of the woman’s body occurs. But this is not all - the main body is also undergoing changes, but, more importantly, it becomes vulnerable. This happens in a natural way: the uterus grows in size, there is a thickening of its walls. In recent metamorphoses, there is a risk of hemorrhage, which in the medical language is called a hematoma.
Such phenomena in the uterus appear not so rarely and, as a rule, in the early stages of pregnancy. It is in the first trimester that the likelihood of detachment of the ovum increases. Retrochorial hematoma during pregnancy may result in its interruption.
Therefore, it is extremely important for expectant mothers to listen to their body and seek medical help in a timely manner.
What is a pathology?
Before figuring out why and where the uterine hematoma appears, you should understand the terminology of the disease itself. The fetus is surrounded by a villous embryonic membrane, which, combining with the uterine epithelium, after a while forms a placenta. As a result, the vessels of the mother and fetus are intertwined. As a rule, it is fully formed after 16 weeks.
As noted above, pregnancy does not always go smoothly, and the fetal egg may peel off, which entails a rupture of capillaries. As a result, an accumulation of blood forms between the wall of the uterus and the fetus, which is called the retrochorial hematoma, in scientific language. Therefore, it mainly happens precisely in the early stages of pregnancy, when the placenta has not yet fully formed.
In medical practice, there is also a phenomenon such as subamniotic hematoma, which occurs infrequently. It occurs as a result of self-resorption without any medical intervention. In this regard, such a concept should not be confused with each other.
Retrochorial pathology can also be in advanced form, which can be observed for periods of more than 16 weeks. In this case, this suggests that the fetus begins to exfoliate directly from the placenta itself. At the same time, the risks and negative effects on the fetus increase significantly.
Causes of pathology
What can cause retrochorial hematoma during early pregnancy? As you know, any disease has its own cause of occurrence, this pathology is no exception. According to statistics, about 70% of expectant mothers develop retrochorial pathology. And since each woman has individual characteristics of an organism, the cause in each case may be different.
The exact causes have not yet been determined, however, there are several main factors contributing to the development of this hematoma. Let us single out 5 main reasons for this phenomenon, which will be discussed later.
Wrong hormonal adjustment
Due to the high level of testosterone and prolactin, the metabolism between the mother and the fetus is difficult, as a result of which it passes with significant impairments. Ultimately, the fetus exfoliates, often due to a lack of progesterone.
To avoid the development of retrochorial hematoma in early pregnancy, doctors prescribe the use of such synthetic drugs as Dufaston or Utrozhestan. If the lack of progesterone has led to extensive detachment of the fetus, then emergency hormone therapy is prescribed, during which Dufaston is used in high doses at strictly defined intervals.
Exceeding the allowable norm of physical activity
Overfatigue can provoke an increased tone of the uterus, and the longer the gestation period, the higher the likelihood that the muscle apparatus will be in a stressed state and may even harden.
An increased tone of the uterus is a condition of its muscles, which may be permanent or temporary. In the latter case, we are talking about contractions during childbirth. Constant reductions can inevitably lead to undesirable consequences, up to the loss of a child.
To treat retrochorial hematoma, pregnant women are given droppers or the necessary medications are prescribed.
Exacerbation of STDs
In this case, an extensive inflammatory process can begin, and it affects not only the reproductive female organ itself, but also the organs located in the pelvis. This leads to the formation of blood clots in the fetal circulatory system, as this is caused by the natural reaction of the female body: platelets are actively produced to suppress the infection.
How does this affect the fetus? The necessary nutrients cease to come to him. It becomes difficult for the chorion to hold onto the surface of the fetal egg, and its detachment occurs. All this leads to the threat of miscarriage.
Frequent Vibration
Such a risk exists in the early stages of pregnancy, about 8 weeks. Due to vibration, the blood circulation of the fetus is disturbed. But waves over time lead to stratification of tissues.
In this regard, doctors try not to conduct an ultrasound examination too often during the first three to four months of pregnancy. This is especially undesirable with a clear threat of miscarriage.
Diseases
Retrochorial uterine hematoma during pregnancy can develop as a result of diseases that are associated with bleeding disorders. And often this is a pathological condition such as thrombophilia. This genetic pathology is characterized by an increased formation of blood clots.
And although in most cases the disease is mild and does not cause much discomfort in patients, it is very difficult for pregnant women to endure a child with such a diagnosis. There is always a risk of placental insufficiency, including placental abruption.
Other reasons
Among other reasons, the following factors can be distinguished:
- The presence of alcohol, tobacco or drug addiction.
- Abnormal development of the genitals.
- Arterial hypertension.
- Long stressful situations.
- Infectious diseases of the genitourinary system.
- Cases of severe toxicosis in early pregnancy.
- Weak immunity of a woman.
- Overheating or hypothermia.
All of these factors can cause the fetal egg to exfoliate from the chorion, and this leads to the formation of retrochorial uterine hematoma.
But how can one independently identify this pathology?
Symptomatology
Usually, retrochorial pathology does not manifest itself in any way during pregnancy. Diagnosis is complicated by the fact that the symptoms of a hematoma are easily confused with the occurrence of any other pathological process. But there are some pronounced signs:
- Pain in the lower abdomen is pulling, the pains resemble those on critical days.
- Weakness persists even after a good rest.
- There is a pulling pain in the lumbar region.
- Unusual vaginal discharge.
Moreover, the last sign is worth increased attention, since danger can lurk here. The color of the discharge can be a light brown or a deep red hue.
With the establishment of retrochorial hematoma and secretions of dark red color, we can talk about the gradual release of blood clots. If they are a bright red color, and even accompanied by pain, then you need to seek medical help. This indicates the formation of a hematoma or even an increase in its size.
As a rule, the hematoma is small, but in general it is a bruise that can independently resolve without external intervention. Only a process can last several weeks.
In the case of an increased hematoma, this negatively affects the development of the fetus, and the risks of spontaneous abortion increase significantly.
Diagnosis of the disease
To make an accurate diagnosis and confirm or refute the presence of a hematoma, a pregnant woman has to undergo a number of important studies. Ultrasound is most often used, since such a diagnosis of retrochorial hematoma is reliable.
A complete clinical picture can be compiled on the basis of completed additional procedures:
- delivery of urine and blood;
- gynecological smear;
- carrying out a coagulogram;
- blood chemistry;
- analysis for STDs;
- study of the hormonal background of the female body.
All this together allows not only to identify the hematoma itself, but also to determine its type, size, structure, location in relation to the fetal egg. You can also find out the tone of the uterus.
Using the obtained data, the specialist establishes the accuracy of the diagnosis and determines the overall picture of the further development of pregnancy, prescribes the necessary treatment.
Treatment features
Depending on the nature of the pathology, its treatment can take place in a hospital or on an outpatient basis, but under the close supervision of a specialist. If there is a suspicion of a hematoma, large loads and stressful situations are contraindicated for a woman. It is necessary to observe peace, to lie, with slightly raised legs, which allows you to normalize the blood flow of the uterus.
In addition to lifting weights, you should refrain from sexual activity. In addition, it is necessary to periodically donate blood to determine its coagulability. Usually, treatment of retrochorial hematoma during pregnancy is carried out in a complex manner with the inclusion of a number of measures:
- Taking medications that stop bleeding.
- Elimination of increased uterine tone.
- Restoring the hormonal background of a woman.
It is also necessary to observe the daily routine and eat right.
Since the majority of medications are contraindicated for pregnant women (especially at the initial stage), specialists select those products that do not have any effect on the expectant mother or the fetus.
For the treatment of hematoma, vitamins are prescribed that strengthen the walls of blood vessels and stop bleeding (Ascorutin, Vikasol and Ditsinon). Good drugs for relieving hypertonicity are considered "No-shpa" and "Papaverine."
Total
Do not be afraid of such a seemingly terrible diagnosis and in no case should you panic. The main thing is to seek medical help in a timely manner. It is good when the hematoma is small and, possibly, serious specialist intervention is not required. But the severe form of retrochorial hematoma can be treated, only all the recommendations of the attending physician must be observed.