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绒毛膜下血肿(SCH)是绒毛膜与蜕膜分离出血，血液集聚在绒毛膜与蜕膜之间形成的血肿。近年来，SCH在孕妇中的发病率逐渐上升，SCH与妊娠结局的关系越来越被关注。本文就SCH的发病机制、对妊娠结局的影响和治疗进行综述，以期更好地预防SCH发生，并对存在SCH症状的孕妇做出合理有效地治疗，使不良妊娠结局发生率最小化。
Abstract：Subchorionic hematoma(SCH) is a hematoma formed by the separation of chorion and decidua, and the accumulation of blood between chorion and decidua. In recent years, the incidence of SCH in pregnancy is gradually increasing, and the relationship between SCH and pregnancy outcome has been paid more and more attention. This paper reviews the pathogenesis of SCH,its impact on pregnancy outcomes and treatment, in order to better prevent the onset of SCH,and make reasonable and effective treatment measures for pregnant women with SCH symptoms to minimize the incidence of adverse pregnancy outcomes.
[1] Hasan R,Baird DD,Herring AH,et al.Association between first-trimester vaginal bleeding and miscarriage[J].Obstet Gynecol,2009,114:860-867.
[2] 胡慧，胡春花，何培芝，等.早期妊娠重度绒毛膜下血肿患者病因探讨及个体化治疗效果研究[J].中国计划生育和妇产科，2020,12:33-38.
[3] Li Y,Wang E,Huang S,et al.Autoantibodies in association with subchorionic haematoma in early pregnancy[J].Ann Med,2021,53:841-847.
[4] So SH,Mochizuki O,Yamaguchi W,et al.Impact of subchorionic hematoma in early pregnancy on obstetric complications:A retrospective cohort study in women who had live births after frozen-thawed embryo transfer[J].Reprod Med Biol,2020,19:398-403.
[5] Rottenstreich A,Amsalem H,Kleinstern G,et al.Outcomes of threatened abortions after anticoagulation treatment to prevent recurrent pregnancy loss[J/OL].Reprod Biomed Online,2017,35:461-467.
[6] 钱建美.免疫球蛋白联合低分子肝素对于绒毛膜下血肿患者的治疗效果、妊娠结局及INF-γ、IL-10的影响[J].中国妇幼保健，2019,34:749-752.
[7] Chen CP,Hsu CY,Su YN,et al.Placental mesenchymal dysplasia associated with antepartum hemorrhage,subchorionic hematoma,and intrauterine growth restriction[J].Taiwanese J Obstetrics Gynecol,2013,52:154-156.
[8] Truong A,Sayago MM,Kutteh WH,et al.Subchorionic hematomas are increased in early pregnancy in women taking low-dose aspirin[J].Fertil Steril,2016,105:1241-1246.
[9] Asato K,Mekaru K,Heshiki C,et al.Subchorionic hematoma occurs more frequently in in vitro fertilization pregnancy[J].Eur J Obstet Gynecol Reprod Biol,2014,181:41-44.
[10] Palatnik A,Grobman WA.The relationship between first-trimester subchorionic hematoma,cervical length,and preterm birth[J].Am J Obstet Gynecol,2015,213:403.
[11] Barinova VV,Kovaleva AV,Dmitrieva MP.Pregnancy outcomes in pregnant women with subchorionic hematoma[J].Int J Biomed,2015,5:137-140.
[12] 韩小雪，潘颖，李瑞满.先兆流产合并绒毛膜下血肿对孕期血压的影响[J].广东医学，2018,39:428-429,433.
[13] Khan RI,Taimoor A,Nazir A,et al.Association of subchorionic hematoma with preterm labour in patients with threatened abortion[J].J Ayub Med Coll Abbottabad,2021,33:451-455.
[14] Hashem A,Sarsam SD.The impact of incidental ultrasound finding of subchorionic and retroplacental hematoma in early pregnancy[J].J Obstet Gynecol India,2019,69:43-49.
[15] Le Gallee M,Lee S,Spence AR,et al.Association between first-trimester bleeding and retained placenta requiring dilatation and curettage[J].J Obstet Gynaecol Can,2021,43:463-468.
[16] 李清，朱瑾，华克勤.绒毛膜下血肿孕妇妊娠结局的荟萃分析[J].中华医学杂志，2016,96:1383-1385.
[17] 王娟.胎盘后血肿和绒毛膜下血肿妊娠结局及影响因素的对比分析[D].大连医科大学，2018.
[18] 伍嘉雯.先兆流产合并绒毛膜下血肿的妊娠结局分析[J].黑龙江医学，2018,42:138-139.
[19] Biesiada L,Krekora M,Krasomski G.Subchorionic hematoma as a risk factor of pregnancy and delivery in women with threatening abortion[J].Ginekol Pol,2010,81:902-906.
[20] Heller HT,Asch EA,Durfee SM,et al.Subchorionic hematoma:correlation of grading techniques with first-trimester pregnancy outcome[J].J Ultrasound Med,2018,37:1725- 1732.
[21] 吴丽静，连成瑛.不同孕周及不同程度的绒毛膜下血肿对妊娠结局的影响[J].福建医药杂志，2021,43:53-55.
[22] 翁毅，陈毕蓝，苏秀梅.伴不同程度绒毛膜下血肿先兆流产的妊娠结局比较[J].中国医药科学，2015,5:56-58.
[23] Naert MN,Khadraoui H,Muniz Rodriguez A,et al.Association between first-trimester subchorionic hematomas and pregnancy loss in singleton pregnancies[J].Obstet Gynecol,2019,134:276-281.
[24] 卫炜，李国静，郭秋云，等.绒毛膜下血肿的临床特点及其妊娠结局分析[J].北京医学，2021,43:46-48.
[25] Ji W,Li W,Mei S,et al.Intrauterine hematomas in the second and third trimesters associated with adverse pregnancy outcomes:a retrospective study[J].J Matern Fetal Neonatal Med,2017,30:2151-2155.
[26] Zhou J,Wu M,Wang B,et al.The effect of first trimester subchorionic hematoma on pregnancy outcomes in patients underwent IVF/ICSI treatment[J].J Matern Fetal Neonatal Med,2017,30:406-410.
[27] Yue M,Ma L,Cao Y,et al.Application of a nomogram for predicting the risk of subchorionic hematoma in early pregnancy with in vitro fertilization-embryo transfer/frozen embryo transfer[J].Front Endocrinol(Lausanne),2021,12:1-9.
[28] Roque M,Haahr T,Geber S,et al.Fresh versus elective frozen embryo transfer in IVF/ICSI cycles:a systematic review and meta-analysis of reproductive outcomes[J].Hum Reprod Update,2019,25:2-14.
[29] Anderson KL,Jimenez PT,Omurtag KR,et al.Outcomes of in vitro fertilization pregnancies complicated by subchorionic hematoma detected on first-trimester ultrasound[J].F S Rep,2020,1:149-153.
[30] Reich J,Blakemore JK,Grifo JA.Comparison of subchorionic hematoma in medicated or natural single euploid frozen embryo transfer cycles[J].Fertil Steril,2020,114:595-600.
[31] Eaton JL,Zhang X,Kazer RR.First-trimester bleeding and twin pregnancy outcomes after in vitro fertilization[J].Fertil Steril,2016,106:140-143.
[32] Naqvi M,Naert MN,Khadraoui H,et al.Subchorionic hematomas and adverse pregnancy outcomes among twin pregnancies[J].Am J Perinatol,2021,38:779-783.
[33] West BT,Kavoussi PK,Odenwald KC,et al.Factors associated with subchorionic hematoma formation in pregnancies achieved via assisted reproductive technologies[J].J Assist Reprod Genet,2020,37:305-309.
[34] 邱月元，何元姣.门诊先兆流产合并绒毛膜血肿孕妇低分子肝素注射治疗的护理及对孕妇不良反应发生的影响[J].中外医学研究，2021,19:110-112.
[35] Grandi G,Pignatti L,Ferrari F,et al.Vaginal alpha-lipoic acid shows an anti-inflammatory effect on the cervix,preventing its shortening after primary tocolysis.A pilot,randomized,placebo-controlled study[J].J Matern Fetal Neonatal Med,2017,30:2243-2249.
[36] 姚祺，黄美霞，李一妹.地屈孕酮联合黄体酮对黄体功能不足性流产患者的临床疗效及对细胞因子的影响[J].生殖医学杂志，2017,26:694-698.
[37] 吴家满，宁艳，廖坚，等.耳穴埋针联合地屈孕酮对早期妊娠先兆流产合并绒毛膜下血肿患者免疫因子及血清CA125的影响[J].中国针灸，2019,39:1046-1050.
[38] 陈茜.先兆流产合并绒毛膜下血肿孕妇的孕早期激素水平与妊娠结局的相关性探讨[J].世界最新医学信息文摘，2019,19:87-88.
[39] 刘晓华，岳洁，卢钺，等.先兆流产合并绒毛膜下血肿孕妇孕早期激素水平与妊娠结局的相关性分析[J].海南医学院学报，2016,22:361-363.
[40] 余转，张歆，吴新财，等.妊娠早期绒毛膜下出血与胎盘脐带附着异常的关系研究[J].临床超声医学杂志，2019,21:782-784.
基本信息:
中图分类号:R714.2
引用信息:
[1]沈冬怡,孙忻,张伟.绒毛膜下血肿与妊娠结局相关性研究进展[J].生殖医学杂志,2022,31(08):1156-1160.
基金信息:
浙江省中医药科技计划(2013ZB093)
2021-10-15
2021
2021-11-30
2022-07-04
2022
1
2022-08-15
2022-08-15