How is a hematoma treated during pregnancy?
Hematomas in the uterus during pregnancy: development and symptoms
Following your medically assisted procreation (MAP) treatment, you took a pregnancy test. You are indeed pregnant! Throughout your pregnancy, you will benefit from medical monitoring by your gynecologist or midwife. During your appointments, various examinations will be offered to check that your pregnancy is progressing properly. Uterine hematomas are among the complications that can be highlighted during these checks. Often benign, they may require rest measures. Find out exactly what a decidual hematoma and a retroplacental hematoma are. What are the associated risks? Also find out how to detect this type of pregnancy-related hematoma. What care can be offered to you if you are affected?
What is a hematoma in the uterus, or intrauterine hematoma?
A hematoma in the uterus is an effusion of blood inside the uterine cavity. It is also called an intrauterine hematoma. This pregnancy-related hematoma corresponds, more precisely, to an accumulation of blood between the placenta or the chorionic tissue and the internal lining of the uterus. There are several types of intrauterine hematomas. The subchorionic hematoma is located between the chorion (the membrane that surrounds the baby, connected to the placenta) and the uterine wall (the endometrium). The decidual hematoma and the retroplacental hematoma are located between the endometrium and the placenta. The blood responsible for the formation of these hematomas comes, most of the time, from a hemorrhage. This occurs because of the rupture of a vein or the detachment of the placental membranes.
What are the consequences of uterine hematomas during pregnancy?
The severity of hematomas in the uterus depends on their location and size. In the vast majority of cases, subchorionic hematoma is harmless. Decidual hematoma often occurs on a small area at the edge of the placenta during the first trimester of pregnancy. This is called marginal decidual hematoma . This can increase the risk of miscarriage . However, this is not systematic. Retroplacental hematoma, which is generally associated with partial or total detachment of the placenta after the 5th to 6th month of pregnancy, is the most worrying form of hematoma. The detachment of the placenta from the uterine wall and the pocket of blood that becomes intercalated between the membranes can lead to a reduction or cessation of exchanges between the mother and the fetus, even causing premature delivery.
What are the symptoms of decidual hematoma or retroplacental hematoma?
If you are concerned about an intrauterine hematoma, you may experience vaginal bleeding that is red or dark in color. You may also feel pain or tenderness in the uterus. You may also not notice any specific signs. Uterine hematoma during pregnancy is diagnosed through a clinical evaluation. An ultrasound is usually performed by the gynecologist to visualize and measure the lesion. Laboratory tests may be performed in addition. In the absence of symptoms, decidual or retroplacental hematoma is commonly detected during a routine ultrasound.
Intrauterine hematomas during pregnancy: what are the risk factors?
The causes of hematomas in the uterus during pregnancy , and more generally the causes of venous ruptures or placental abruptions that lead to their appearance, are not clearly identified. However, several factors likely to promote the occurrence of these pathological conditions have been highlighted, including:
- Tobacco consumption,
- The presence of abdominal lesions,
- Chronic or pregnancy-induced high blood pressure,
- The age of the pregnant woman (over 40 years),
- Chorion infections,
- Vasculitis and other vascular disorders,
- Abdominal trauma.
What is the management in case of hematoma in the uterus during gestation?
If the gynecologist detects a subchorionic hematoma or a marginal decidual hematoma , he will ask you to limit your activity and will set up closer monitoring. Small hematomas resolve spontaneously most of the time. If your hematoma does not disappear and increases in size, certain preventive measures will be decided, for example absolute rest and sexual abstinence. Retroplacental hematoma can constitute a medical emergency. If it occurs, hospitalization or even rapid delivery may be necessary. Vaginal delivery after induction is possible if the pregnancy is at term, in the absence of contraindications imposed by the condition of the mother or the baby.
When should you consult a doctor if you have bleeding during pregnancy?
Vaginal bleeding is relatively common during the first trimester of pregnancy. It may be linked to the appearance of a hematoma in the uterus , but not only. The cervix, which is more fragile during pregnancy, may bleed in particular after a gynecological examination or sexual intercourse. A small amount of blood may also flow at the very beginning of pregnancy following the implantation of the embryo in the uterine lining. Bleeding in the first trimester is not alarming. However, it is advisable to consult your gynecologist or midwife if you experience it and it intensifies, continues or is accompanied by abdominal pain, or simply if it worries you. In the event of genital bleeding from the second trimester onwards, you must go to the maternity ward urgently in order to obtain rapid and appropriate care.
Do you have risk factors and are you worried about uterine hematomas during pregnancy? Do you have other concerns about your PMA journey and your upcoming pregnancy? In order to best support you during your PMA treatment, IVI clinics offer their IVI Care program . This includes all the examinations and analyses necessary to assess your fertility, as well as psychological support to help you overcome any anxieties. Do not hesitate to contact us if you have any questions or if you would like more detailed information.
