home » Miscellaneous » How to understand that a hematoma comes out during pregnancy. Reasons for the formation of retroamniotic, intrathecal or extramembrane hematoma on the body of the uterus during pregnancy, and can it be cured without risks to the child

How to understand that a hematoma comes out during pregnancy. Reasons for the formation of retroamniotic, intrathecal or extramembrane hematoma on the body of the uterus during pregnancy, and can it be cured without risks to the child

A hematoma in the uterus during pregnancy is an active accumulation of blood in areas of damage to organs or tissues, resulting in the formation of a small vacuole containing either liquid or clotted blood.

During pregnancy after 16 weeks malignant tumor
methods of prevention Not all neoplasms
in pregnant women, the length of the uterus is important

Most women, after undergoing an ultrasound scan, and learning that there is such a problem in the uterus, raise a panic. Such a reaction, of course, is understandable, because a tumor in the uterus is a very dangerous process that causes separation gestational sac which can eventually lead to miscarriage.

The causes of this disease

There are a lot of reasons for the occurrence of accumulations of blood clots in the uterus in women during pregnancy:

change and violation of the general hormonal background;
the impact of excessive physical exertion on the body of a pregnant girl;
stressful state;
traumatism;
nervous stress;
various infectious diseases;
perfect sexual intercourse;
the use of alcoholic beverages;
jumps in blood pressure.

Also, experts note that the appearance of a tumor in the uterus can be caused by weakness of the vessels of this organ or the placenta. The reason for the change in blood vessels is a violation of the correct metabolism.

The process of formation of a hematoma in the uterus during pregnancy is interpreted by many experts in this way.

Initially, there is an impact of any factors, as a result of which the fetal egg is separated from the walls of the uterus.
At the site of separation, the vessels form a cavity with a blood clot.
This blood clot is called a retrochorial hematoma. Looking at the photo, you will see a hematoma in the uterus during pregnancy.

How to detect in time

Varieties of pathology

There are only two types of hematomas.

Occurs up to 16 weeks, i.e. on early dates called retrochorial.
It appears after 16 weeks - is called retroplacental.

A hematoma in the uterus during pregnancy has certain symptoms, which are divided into three stages according to their severity:

at the first, women have a small formation, which can be determined by conducting an examination, this stage is also called asymptomatic;
the second stage is characterized by pain in the abdomen, which are pulling, and blood clots are also possible;
the third stage is the most severe, with this option, a woman experiences a sharp decrease in blood pressure, cramping pains, severe bleeding, fainting is possible, discharge in the presence of a hematoma will be bright red.

Pathology after 16 weeks - called retroplacental

Diagnostics and methods of therapy

It is possible to diagnose the development of a malignant tumor with the help of ultrasound, and a young mother will also have to take additional blood, urine, hormones, HIV tests and, most importantly, discharge tests.

Treatment of a hematoma during early pregnancy is of a special nature, because if no measures are taken to destroy malignant tumors, a miscarriage may subsequently occur. Rare cases can lead to a threat to the life of the expectant mother if the moment of fetal detachment starts. It was then that the doctors carried out an emergency termination of pregnancy.

Timely treatment allows you to stop the growth of such formations, as a result of which there will be no danger to the fetus. Therapy of uterine hematoma during pregnancy is different, the presence of discharge Brown indicates the correctness of the course of treatment being undertaken.

Suspicion of a malignant tumor

If you suspect a malignant tumor, you should have an ultrasound examination by your doctor. On the basis of the conclusions received, the doctor concludes whether it is worthwhile to carry out treatment or whether it is necessary to continue monitoring the behavior of the resulting tumor.

But, if treatment of a hematoma in the uterus during pregnancy is prescribed, the woman will need to do an additional examination with tests, on the basis of which the doctor will prescribe the necessary medications, and also clarify the course of treatment. As a rule, therapy must be carried out in a hospital under the supervision of specialists.

With this treatment, you should strictly follow the diet, as well as bed rest.
The gynecologist prescribes drugs that improve blood circulation, and also help prevent embryonic hypoxia.
All drugs for a pregnant woman are prescribed in accordance with the severity of the tumor.
Among the means that stop bleeding and, accordingly, the growth of a dangerous disease, experts note and advise the use of the drug Dicinon.
by the most safe means that eliminate tone are No-shpa, Papaverine.
In addition to drugs, the patient is prescribed vitamin therapy.
During the course of treatment, it is strictly forbidden to have sex.
It is necessary to strictly observe the diet, including the necessary fruits, vegetables, as well as drinking plenty of raw water.

Basic preventive methods

To further prevent the growth of a hematoma, it is necessary to raise the pelvis in the supine position, which improves the outflow of blood, and, consequently, will lead to the gradual resorption of the tumor.

Among the preventive measures for the formation and development of uterine hematoma during pregnancy, experts note the following procedures:

conducting a complete examination of the body of the expectant mother;
effective course of treatment of infectious diseases;
therapy of vascular pathologies;
identification of existing hereditary diseases.

To identify the exact symptoms, you need to read the reviews of women who treated uterine hematoma during pregnancy.

Natalya Bykova:

At the next ultrasound examination, doctors found a tumor measuring 12 * 10 mm, the gestational age was only 7 weeks. The decision to eliminate the malignant formation was taken immediately. The gynecologist who observed me sent me for additional blood, urine, HIV, etc. tests. After passing the tests, I was assigned to a hospital, where I was given injections for 12 days, and also put a dropper with vitamins, and was additionally prescribed to drink Duphaston. After the end of the treatment period, there was no trace of the tumor left.

Svetlana Viktorova:

During her pregnancy for a period of 6 weeks, she began to feel slight, but rather unpleasant pains in the lower abdomen. The consequence of this was the decision to go to a paid clinic for diagnostics. The analysis showed the presence of a hematoma in the uterus during early pregnancy with a size of 13 * 8 mm. The gynecologist suggested a course of treatment in the clinic. The therapy lasted 10 days, I, accordingly, did not refuse it. During treatment, she initially took various pills brought by nurses. After I found out that among them were valerian for calming, as well as Magne B6. Additionally, therapy was accompanied by a dropper. It is also worth noting that hematoma had to be treated with bed rest, doctors advised to sometimes raise the legs to improve blood circulation. At the end of the 10-day course of treatment, the malignant tumor resolved. Now I sit and raise my baby. There are no more fears.

Olga Frolova:

At 12 weeks of gestation, the examination revealed a hematoma in the uterus measuring 2.1 by 0.8. There was no pain or discharge. After the ultrasound, the doctor prescribed Duphaston, Magne B6 and full bed rest. After 10 days of home treatment, the hematoma decreased to 1 cm - by 0.5 cm. After a certain time, it resolved on its own. So I advise all pregnant women to remain calm and take care of their health.

: Borovikova Olga

gynecologist, ultrasound doctor, geneticist

26.09.2017

During the bearing of the fetus, the woman's body undergoes many changes, sometimes any 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 evaluate the prognosis. We will talk about an internal hematoma, but about the bruises on the abdomen left after a cesarean section, you can find out from another article.

After fertilization of the egg, a fetal egg will be formed, 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 essential for the formation of amniotic membranes. Subsequently, such membranes serve as protection and nutrition for the embryo. At the very beginning, the fetal egg is in a vial with a liquid (amnion), around which there is a shell - the chorion.

Sometimes the fit of the fetal egg to the uterus is not quite 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 shell of the fetus. This space, due to active circulation, is quickly filled with blood. Against the background of damage to the vessels connecting the 2 surfaces, the blood accumulates, and then goes out through the hole in the cervix. It is impossible to say exactly how long the hematoma resolves - it all depends on the specific conditions.

Hoping that everything will go away on its own is dangerous, since the same symptoms occur with different diseases. During pregnancy, both the mother and the baby are at risk. Therefore, it is so important to immediately go to an obstetrician-gynecologist if you feel unwell and incomprehensible symptoms.

Causes of hematoma formation

Factors that can provoke the formation of a hematoma are as follows:

hormonal disbalance. Due to a deficiency or excessive number of certain hormones, the attachment of the fetal egg to the uterine endometrium does not occur as it should;
due to heavy physical exertion of the mother, the uterus does not function well. Therefore, against the background of pathology, bed rest is more often prescribed;
psycho-emotional shake-up, nervous strain;
anomalies 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 the detection of a hematoma and its development, doctors distinguish 2 of its types:

Retrochorial. It usually manifests itself in terms of 1-16 weeks, when the placenta is not fully formed. The cavity is located between the uterus and the chorion. Ultrasound does not reveal a hematoma, because due to the low load on the vessels, the area of \u200b\u200bthe hematoma is small, there are no obvious symptoms;
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 is quickly filled with blood, and if no action is taken, it poses a threat to the life of the pregnant woman herself and the fetus. Despite the possible risks, and this diagnosis should not be a cause for excessive nervousness, the doctor will explain what and how to do in order to avoid complications.

In some pregnant women, the diagnosis is not determined until childbirth - they have no bruising, bleeding, or any signs of pathology. During childbirth, when the placenta departs, 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. A woman is warned that there may be a violation of blood circulation in the pelvis and legs, which is fraught with thrombophlebitis if you experience serious physical exertion.

How the 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 there is no great danger. There may be rare spotting in a small amount;
average. It is characterized by aching pain in the lower abdomen. Sometimes pain is given to the lumbar region. Blood appears regularly;
heavy. A pregnant woman often has a stomachache below, like contractions, bleeding is profuse. Perhaps dizziness, pressure drop, fainting. With this course of the disease, a caesarean section is performed or the pregnancy is terminated, since this threatens the life of the mother.

Diagnosis and prognosis of hematoma

Before you start any treatment, you need to diagnose. The only suitable option in this case is 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 fetal egg. It is bad if the formation of a hematoma takes place at the site of the placenta 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 the hematoma has clear contours and even edges, and the contents are homogeneous, then this is a fresh formation. Over time, the hematoma acquires fuzzy contours, its edges become uneven, and the contents are heterogeneous;
hematoma size. The larger the dimensions of the hematoma compared to the dimensions of the fetal egg, the higher the likelihood of abortion.

In about 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 \u200b\u200bwhich 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 \u200b\u200bwhich 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 fetal egg is completely separated from the uterine wall. Possible spontaneous abortion.

Treatment of a hematoma in a pregnant woman

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

bed rest, as excessive abdominal tension increases blood circulation;
the use of drugs that stop bleeding;
taking funds from spasm of the uterine muscles;
intake of suitable vitamins and minerals in the complex;
improvement of blood circulation in the placenta, prevention of hypoxia in the fetus.

The main preventive measure against 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 muscles of the uterus, pregnant women are prescribed No-shpu, Magne-B6, Papaverine. Progesterone preparations Utrozhestan and Dufaston are necessarily prescribed. Recommended soft sedatives, which are not prohibited for pregnant women, as well as folic acid and vitamin E. In order for the hematoma to resolve faster, and the child does not develop hypoxia, you need to take Actovegin, a remedy that improves the supply of the fetus with nutrition.

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

Any measures should be discussed with the attending physician, 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 of diseases of the genitourinary system.

At the earliest stages of gestation (up to 16 weeks), the placenta has not yet formed. But there may be signs of detachment from the wall of the uterus of its predecessor - the chorion. This is how a hematoma occurs in this organ, which, in turn, becomes a common cause of abortion in the first trimester.

The embryo is a small vial with liquid contents and an embryo. The shell that surrounds it is called the chorion. It is necessary for the attachment of the fetal egg in the uterus and its nutrition. Implantation occurs due to the immersion of the fetal vesicle into the endometrium. Blood from microvessels freely washes it, from which the embryo takes oxygen and nutrients. Gradually, the chorionic villi grow into the wall of the uterus and the placenta is formed.

Causes of a hematoma

Hematoma is the accumulation of blood in a delimited cavity. Small formations at the site of soft tissue injuries do not cause significant harm, quickly disappear on their own. But their occurrence in the uterus at an early stage of gestation can end sadly.

A hematoma located behind the chorion (retrochorial) is the result of an abortion that has begun. The accumulation of blood between the fetal egg and the wall of the uterus gradually increases, which leads to a miscarriage. But growth can stop, then the child will be saved.

The following factors are the reasons for the development of the condition.

Hormones. A lack of progesterone leads to poor preparation of the endometrium. The remaining deficiency of the hormone disrupts implantation, does not reduce the tone of the smooth muscles of the uterus and immune surveillance. Therefore, all conditions are created for the rejection of the fetal egg.
Anomalies of development. Improper development of the fetal egg itself, the presence of chromosomal rearrangements lead to disruption in the synthesis of many substances necessary for the life of the embryo. Therefore, the body tries in this way to get rid of the defective embryo.
Gynecological diseases. Inflammatory processes in the uterine cavity, appendages or ovaries affect the state of the entire reproductive system. Often chronic endometritis is main reason miscarriage. Fibroids, endometrial polyps also disrupt the implantation process. Sometimes the embryo tries to gain a foothold over the myomatous node. But this often ends with the formation of a hematoma and miscarriage.
Infection. Chlamydia, viral diseases in a latent form, as well as transferred in the first trimester, can damage the embryo, resulting in its death.
Endocrine pathologies. Diabetes mellitus, thyroid pathology can affect the state of the embryo and lead to chorion detachment.
Intoxication. Smoking, drinking alcohol affect the state of microvessels, lead to their spasm or a sharp expansion.
Autoimmune diseases. Pathological processes in systemic lupus erythematosus, rheumatoid arthritis, antiphospholipid syndrome associated with the formation of antibodies to self-proteins. The resulting immune complexes damage blood vessels, disrupt the nutrition of the embryo, and cause its rejection.
Weight lifting. Heavy physical labor is accompanied by muscle tension. An increase in intra-abdominal pressure can cause uterine tone. This is especially dangerous if there are other conditions that can lead to miscarriage.
stress. Hormonal regulation in the female body is very dependent on the general emotional state. If future mom is in a state of constant stress, then adrenaline, norepinephrine and other stress hormones can affect the secretion of other biologically active substances. Therefore, against the background of prolonged nervous tension, pregnancy is difficult and it is just as difficult to maintain.

Other diseases can affect gestation internal organs, pathology of the heart and blood vessels, early toxicosis. Therefore, doctors always recommend planning a baby to reduce the risks.

External signs

Those who are already aware of their pregnancy should be attentive to changes in the sensations or nature of the discharge. Normally, in the initial stages in a healthy woman, leucorrhea does not become plentiful and does not change color. The appearance of a bloody daub is a reason to immediately go to the doctor. Pay attention to the intensity of the color. If the blood is bright scarlet, then this is a sign of a miscarriage. Dark- brown discharge- an indicator that the hematoma gradually resolves, and part of it comes out.

In most cases, pain in the lower abdomen appears before the discharge. It has a different intensity, resembles contractions or painful periods. Sometimes it gives to the lower back, leg, groin.

General well-being may change. There is weakness, dizziness, anxiety. Pressure drops, tachycardia appears.

If at the same time the pain increases and the amount of blood released increases, this indicates that the miscarriage is in the active phase and it is impossible to maintain the pregnancy.

Instrumental and laboratory diagnostics

It is necessary to confirm or refute the diagnosis as quickly as possible. The possibility of saving the child will depend on the time of the start of treatment. Therefore, the first and most informative diagnostic method is ultrasound. It can be performed by the transabdominal method, but the vaginal method is more accurate and does not require a filled Bladder at an early date.

Signs of a hematoma on ultrasound are the following changes.

The wall of the uterus. It thickens, but not on the entire surface, but locally, at the site of attachment of the fetal egg. Sometimes the phenomenon of hypertonicity can occur as a reflex reaction to the introduction of a vaginal probe. To refute the suspicions, you need to repeat the examination through the abdominal wall and compare the results. If the tone along the anterior or posterior walls of the uterus is preserved, then this indicates a threat of interruption.
Fertile egg. It changes its shape and becomes like a drop or a boat. This is a consequence of the pressure on him of the thickened part of the uterus.
Hematoma. On ultrasound, you can see the retrochorial hematoma itself. This diagnosis will be correct until 16 weeks of pregnancy. After this period, this organ is called the placenta, and similar processes in it are called detachment. To assess the dynamics, the localization of the hematoma and its size are determined. During the re-examination, it will be possible to compare the obtained data and evaluate the effectiveness of the treatment.

A patient with such a diagnosis is subject to mandatory hospitalization in the gynecological department. Upon admission to the hospital, the following tests are additionally carried out:

clinical analysis of blood and urine;
biochemical blood test;
coagulogram;
blood type and Rh factor;
vaginal smear.

According to indications, other studies can be carried out - ECG, tests for hormones and genital infections.

Ways to prevent miscarriage

To stop the pathological process, a therapeutic and protective regimen is necessary. It includes not only restriction of movement and physical activity, but also emotional calmness.

Diet

The pregnant woman is transferred to a diet that reduces the risk of gas formation and the development of constipation. Excluded from the diet:

legumes;
cabbage;
black bread;
coarse fiber;
apples.

It is also necessary to give up chocolate, coffee, tea. They stimulate nervous system, which is not at all necessary during maintenance therapy.

Sedatives and antispasmodics

For sedation, valerian extract, Novo-Passit tablets are used. Some doctors allow the use of motherwort tincture, but it contains alcohol, which during this period can be harmful.

The next direction of treatment is to reduce the tone of the uterus. Antispasmodics help with this:

"Papaverine";
"No-Shpa".

Medicines in the acute phase are used in the form of injections, then they switch to suppositories or tablets. The magnesium solution also reduces the tone of the uterus. It is administered intravenously by drip. side effect is a decrease in blood pressure. On maintenance treatment, intravenous infusions are replaced by taking Magne-B6 tablets.

Hemostatic agents

The following medicines are needed to stop the bleeding.

"Etamzilat". It is administered intravenously, intramuscularly. Quickly eliminates bleeding, but does not lead to hypercoagulability and the formation of blood clots. Can be used in tablets as maintenance therapy.
Vikasol. An analogue of vitamin K, one of the blood coagulation factors. It is used as a maintenance treatment, since it must accumulate in the blood to stop bleeding.
"Ascorutin". The composition includes vitamin C, which is necessary for strengthening the vascular wall.

Hormones

The need for hormone therapy is determined on an individual basis. In some cases, before prescribing progesterone, an analysis is performed to confirm its deficiency. Sometimes the doctor is guided by clinical symptoms, a woman's history. These drugs are used.

Very often, expectant mothers who consult a doctor about abdominal pain and spotting discharge are diagnosed with a hematoma on an ultrasound scan. How dangerous is this and why is it happening?

What is a hematoma during pregnancy?

Strictly speaking, this is an accumulation of blood in absolutely any tissue or organ. Its simplest example is a banal bruise on the skin, formed after an injury or bruise. Similar accumulations of blood can be observed in the liver, spleen, kidneys, subcutaneous fatty tissue. The pregnant uterus is no exception.

Hematomas in early pregnancy are:

Posterior membranes.

In the first case, blood is poured into the space between the place of attachment of the embryo to the mucosa and the wall of the uterus itself. This situation is often referred to as early chorionic abruption or placental abruption after 16 weeks. In the case of a retrochorial hematoma, a kind of " vicious circle”: due to the detachment of the chorion, the vessels that feed it are damaged, bleeding occurs, and the blood accumulating there further exfoliates the embryo from the walls of the uterus.

In the second case, the blood pours out and accumulates between the fetal membranes and the wall of the uterus. Such hematomas are less dangerous, but if they are large, they can also contribute to abortion.

Why do pregnant women have a hematoma?

There are many reasons for the formation of blood accumulations in the pregnant uterus. They are conditionally divided into direct and indirect.

The direct causes of violation of the integrity of blood vessels and the formation of hematomas include:

pelvic and abdominal trauma. Often, detachment of the fetal egg is formed as a result of falls, blows to the stomach, road accidents, less often against the background of violent sexual intercourse.
the same direct reasons include some medical manipulations: amniocentesis, chorionic villus biopsy and other serious interventions.

There are many more indirect reasons:

Progesterone deficiency causes rejection of the uterine mucosa, provoking the formation of retrochorial hematomas.
Infectious processes: STIs, streptococci, staphylococci, cytomegalovirus, herpes and others.
Blood coagulation disorders. Interestingly, there is not always a decrease in blood clotting. As a rule, most often the constant formation of hematomas and detachments of the chorion is associated with increased blood clotting - thrombophilia.
Bad habits: smoking, alcoholism, drug addiction.
Arterial hypertension or sudden uncontrolled pressure rises.
Abnormal attachments of the chorion: its marginal or central location is more often associated with episodes of detachment and bleeding.

Symptoms of a hematoma

By itself, a hematoma may not manifest itself in any way until the clotted blood begins to leave the cavity. Therefore, the main symptom of this condition is brown spotting discharge from the genital tract.

The discharge has a characteristic dark brown color, since the blood in the cavity has already coagulated and the bleeding has stopped. Such a "daub" can continue for a long time - depending on the volume of the hematoma, until the cavity is cleared of blood and clots.

Therefore, we can say that the appearance of brown discharge is a more favorable sign than the appearance of fresh scarlet blood. The last symptom indicates ongoing bleeding.

In some patients, this may be accompanied by dull aching pains in the lower abdomen and lower back. But more often, such complaints in women do not occur at the time of the appearance of a “daub”, but about 5-10 days before it - just at the time of the onset of hematoma formation.

Diagnosis of a hematoma

Determining the detachment of the chorion is quite simple. Obstetricians always mean its presence with classic complaints of a pregnant woman.

Ultrasound is enough to confirm the diagnosis. An ultrasound clearly shows the hematoma itself, its location, contours, degree of organization: that is, how long ago it was formed. Also ultrasonography used to monitor the hematoma and the condition of the fetus in dynamics.

Hematoma treatment

For treatment you need:

Sexual and physical rest.
The use of hemostatic drugs: etamsylate, calcium gluconate, ascorutin, tranexam, vitamin K and others.
Antispasmodics to relax the uterine wall. Excessive tone contributes to the progression of the exfoliation of the embryo from the wall, therefore, papaverine, drotaverine, and magnesium preparations are used to treat this condition.
In the case of confirmed thrombophilia, on the contrary, special “blood thinners” are used: aspirin and low molecular weight heparins.
In the variant of progesterone deficiency, it is important to prescribe replacement therapy in time (Dufaston, Crinon, Susten and others).
It is important to understand that in the case of continued heavy bleeding, it is often necessary to perform curettage of the uterine cavity. In such cases, the embryo has most often already died, and the woman risks her health against the background of bleeding.

Alexandra Pechkovskaya, obstetrician-gynecologist, specially for the site

Useful video

A hematoma is a hemorrhage under the skin, but simply a bruise. A bruise is associated with a bruise. What is the surprise of women when such phenomena are found in the uterus during pregnancy. The diagnosis immediately leads to anxiety. The panic is not unfounded. Hematoma during pregnancy is evidence of pathology.

The fetal egg, a complex structure surrounding the embryo, exfoliates from the walls of the reproductive organ. Pathology may not manifest itself for a long time. It is detected at the first ultrasound examination at the end of the first trimester of pregnancy. Bleeding is dangerous. They threaten the successful course of pregnancy.

Expectant mothers often learn about a hematoma in early pregnancy only after an examination. A gynecologist can detect a hematoma in the uterus no earlier than 5-8 weeks. What is a hematoma? What does the accumulation of blood in the cavity formed between the walls of the uterus and the fetal egg indicate?

The reproductive organ is damaged as a result of various reasons. At the site of damage, a cavity is formed in which life-giving moisture accumulates. The accumulated blood is liquid or already coagulated. If a hematoma is found in the uterus during pregnancy, the gynecologist prescribes treatment. This helps to carry the pregnancy and protect the life of the newborn.

From what arises

There are many factors contributing to the occurrence of uterine hematoma in early pregnancy. These include:

hormonal imbalance,
weight lifting,
ecology,
injuries and bruises of the abdomen,
deviations in the development of the embryo,
gynecological diseases,
toxicosis of the second half of pregnancy,
bad habits of the expectant mother.

The cause of hormonal imbalance during pregnancy is thyroid dysfunction. This organ releases hormones into the blood, which are involved in the regulation of hormonal levels. Very often, infertility is associated with thyroid dysfunction. But it happens that a woman was able to get pregnant, and gestation is jeopardized. Rejection of the placenta creates a hematoma. Hidden pathologies of the endocrine organs can manifest themselves in early pregnancy by detachment of the fetal egg.

Feasible physical activity is useful during pregnancy, but lifting weights threatens to weaken muscle tone and damage to small vessels. But some mothers also have excessive loads, which should not be allowed. An unfavorable environment can poison the body of a future mother and baby. This applies to a large extent to residents of industrial areas.

Injuries and bruises of the abdomen during pregnancy are fraught with internal bruising. Falls on the stomach are especially dangerous. If the development of the embryo went wrong, deviations appeared, then the body reacts by rejecting the non-viable embryo. Sexually transmitted diseases lead to the pathology of pregnancy. In this regard, syphilis is especially dangerous.

To avoid bruising, pregnancy should be planned. At the planning stage, undergo an examination to eliminate all possible negative factors. Carrying a child is a difficult period that radically changes the lifestyle of parents. It requires giving up bad habits and attentive attitude to your health.

Possible complications and consequences for the body

Hematomas are different. The degree of threat depends on the properties and size of the cavity filled with blood. If a mild neoplasm appears at 5-8 weeks of pregnancy and is not associated with any negative feelings, then the pregnant woman will know about it after the birth of the baby.

A severe degree of hemorrhage poses a serious threat to the course of pregnancy, the health of the mother and the life of the baby. The mother has the possibility of developing post-hemarrogic anemia. This is the result of blood loss, from which the fetus also suffers. The blood delivers oxygen to the fetus. It is not enough, oxygen starvation begins. It is dangerous for the life and development of the child. The simplest consequence of such a hematoma is mental and physical development in a newborn. In the worst case, hemorrhage threatens with placental abruption: blood floods the endometrium, tissues die off.

In early pregnancy

Knowledge is power. A young mother needs to know what dangers await her on the thorny path of motherhood. Different kinds uterine hematomas during early pregnancy is not a frequent phenomenon, but it happens. It happens that early signs of trouble appear. Sometimes a woman learns about the problem from the results of an ultrasound scan. This occurs at the end of the third trimester at week 10. The growth of the embryo invariably leads to an increase in the uterus. The growing organ is more accessible for visual inspection and conclusions about its condition. Therefore, an accurate diagnosis is possible in this period. Hematoma is a serious threat to bearing a child. She threatens with detachment of the fetal bladder. If treatment is not started on time, the pregnancy will end in miscarriage.

Any pathology has external manifestations. They are not always correctly interpreted, but they are. For any pain in the abdomen of a pregnant woman, you should seek the advice of your gynecologist. The doctor will conduct an examination and prescribe diagnostic procedures. For a more accurate history, the mother should not hide any details of her personal life. She should be given truthful information about the state of her health and the health of the baby's father. So the specialist will be able to decide what caused the deviation in the normal course of pregnancy: metabolic disorders, trauma, stress, any diseases or other factors.

Symptoms of education

A mild degree of hematoma may be asymptomatic. They learn about it at an ultrasound examination or at the time of childbirth. Moderate hematomas have some signs:

Aching pain in the lower abdomen or in the lumbar region. They are comparable to menstrual pains, but are similar to pain during inflammation of the organs of the genital area.
Feeling tired, weak, especially in the evening.
With a hematoma of moderate severity, weak brown discharge appears. About such bleeding they say that they are "smeared".

Symptoms of severe hemorrhage repeat the signs of moderate severity, but are more pronounced:

Pain in the lower abdomen and lower back severe. They are similar to those that occur with severe inflammation of the genital organs (endometritis or adnexitis).
Pronounced hypotension. The pressure drops in the evening.
The pains are accompanied by copious bloody discharge, as during menstruation.

A severe form of hematoma creates a real threat of miscarriage if it passes in the first trimester.

Small deviations of symptoms towards relief of the condition (yesterday my stomach hurt a lot, but today it’s less) should not please my mother. Hematoma of the uterus requires the immediate intervention of a specialist and the start of treatment.

What are hematomas

By the nature of the hemorrhage, several types of pathologists in the uterus are distinguished:

Subchorial is the earliest possible uterine hematoma during early pregnancy.
Retrochorial - the result of detachment of the chorion from the wall of the uterus and filling the cavity with blood.
Retroplacental - pathology of the second trimester, characteristic for 15 weeks.
Retroamniotic - filling the cavity formed by the walls of the uterus and the amniotic capsule with blood.
Subamniotic - looks like retroamniotic, but occurs at a later date.
Intrauterine - occurs when the walls of the uterus are damaged.

When assessing the possible threat to the woman in labor and the baby, the size of the hematoma is important. They indicate the severity of damage to perinatal structures.

Retrochorial

The chorion is the layer that lines the inside of the uterus during the first half of pregnancy. Over time, it gradually transforms into the placenta. When certain negative phenomena appear in the body of a woman or child, a detachment of the fetal egg occurs. The resulting cavity is filled with blood clots that get there from the blood vessels supplying the uterus. This is a retrochorial hematoma of the uterus. During pregnancy, such a pathology is possible.

The severity of the pathology and further prospects for pregnancy depend on the area of the hemorrhage. Detachment of a third of the fetal egg is a bad sign. It threatens the death of the fetus in the uterine cavity. The exact mechanism of the milk phenomenon is still a mystery.
The process of rejection of the outer fetal membrane or placenta and the filling of the cavity with fluid is called extra-shell hematoma. During pregnancy, the shell may begin to peel off at any stage. If this happens in the later stages and poses a threat to the life of the child, then they resort to the help of a caesarean section. The main indication for such a decision is the viability of the fetus.

Subchorionic

Subchorial hematoma is the most common abnormality during early pregnancy. The condition is dangerous by an arbitrary exit of the embryo. At the first malfunction in the body: pulling pains in the lower abdomen and brownish discharge, you should quickly contact an obstetrician-gynecologist. If the size of the hemorrhage is small, then it is necessary to monitor its development.

Retroplacental

This form of hematoma is typical for the second trimester. The placenta, as an organ, is formed only by the sixteenth week. Retroplacental hemorrhage occurs in the vessels of the placenta and is characterized by a number of signs, both from the health of the mother and from the behavior of the fetus.

A woman complains of severe pain in the lower abdomen. Bloody discharge appears, the tone of the uterus increases. These are considered dangerous symptoms. The hematoma stimulates the reproductive organ to get rid of the fetus. For the embryo, this does not pass without a trace. The child has an increased heart rate, which is replaced by bradycardia. He seems to sense danger and reacts with fear.

Retroamniotic and subamniotic

Retroamniatic hematoma does not show any external signs. This diagnosis is made by ultrasound at about 12 weeks. Most often, it does not threaten the normal course of pregnancy. This type of hemorrhage refers to intershell hematomas: blood accumulates between the amniotic membrane and the wall of the uterus. The diagnosis made requires constant monitoring. This is necessary in order to timely prevent the growth of hemorrhage.

Subamniotic hematoma is not dangerous. If it is small 3-4 mm, then it resolves itself or comes out in the form of blood clots.

Intrauterine

This pathology occurs with the growth of the fetus and the weak walls of the uterus. The organ cannot withstand stretching and suffers damage to the blood vessels that simply permeate it. Among all hemorrhages, this hematoma is the most dangerous. Life-giving moisture penetrates into the reproductive organ, which can lead to tissue necrosis. With a uterine hematoma, it is possible to convey and protect the fetus, but the woman requires urgent hospitalization.

Hemorrhage is the result of the development of the uterus and fetus. Arising in the last trimester of pregnancy, it can kill an unborn baby. If the process progresses, then resort to caesarean section or artificially induce labor. This helps to save the life of a small person.

Methods for diagnosing hematoma

The main method for diagnosing hematoma during pregnancy is ultrasound. It gives the most accurate results. During the examination, the doctor should pay attention to some points:

location of blood collection
size of the hemorrhage
the volume of fluid in the cavity,
general appearance of a hematoma,
structure of education
uterine tone.

All of this information is important. The impact of the hematoma on the membrane surrounding the child depends on the location. The size of the hemorrhage and the volume of fluid indicate a danger to the development of the baby. The general appearance and structure testify to the prescription of its existence. The convulsive state of the uterus is a confirmation of readiness for a miscarriage.

The first ultrasound examination is performed at 12 weeks. But other tests are given by a woman regularly. Their results may be an indirect confirmation of the presence of a hematoma in her. Of great importance are the analyzes of the blood group of the father and mother. Problems with carrying a pregnancy can occur when the Rh factor of the mother and father does not match. Pregnant women are given the following tests and samples:

General blood analysis. It gives a general idea of the health of the expectant mother.
A clinical urinalysis allows you to confirm or refute possible kidney problems and late toxicosis.
Blood clotting test. The result of this analysis is very important during childbirth.
A biochemical blood test gives an idea of the presence of certain diseases that threaten pregnancy.
Dopplerometry of the embryo is a confirmation of the correct development of the baby, the correspondence of its size to the gestational age.
Hormone tests. Only with the help of them is a conclusion made about the state of the hormonal background.
Analysis for sexually transmitted infections.

Diagnosis and treatment of hematoma are closely related.

Treatment

Properly prescribed therapy makes successful treatment of hemorrhage. In ninety-five percent of cases, it is possible not only to keep the pregnancy, but also to make it safe for the mother and child. With hemorrhage, special drugs are prescribed:

Sometimes drugs that provide hormonal support are prescribed. Their choice is made strictly on the basis of analyses. Treatment is prescribed only by a doctor. Even if the expectant mother is aware of how to treat hematomas during pregnancy, it is impossible to self-medicate. The risk is not justified. Choice medicines depends on the results of the tests and diagnostic studies. It is unlikely that anyone will be able to assess the state of their health without resorting to modern diagnostic methods.

How does a hematoma resolve during pregnancy

An entry “Hematoma in the organization stage” appeared in the outpatient card. This indicates that during pregnancy, the neoplasm can resolve on its own. With a high degree of probability, this applies to small hemorrhages, the area of \u200b\u200bwhich does not exceed a quarter of the fetal egg. When such an entry appears, several rules must be observed:

Avoid intimacy.
Stimulate normal bowel function.
Lie down more often with your feet above your head.

Resorption of any hematoma is possible. The mechanism of formation of this pathology is poorly understood. Only one thing is clear: the cause disappears, the effect disappears. You cannot completely rely on chance. If a hemorrhage is detected, even one that is in the process of resorption, the advice of a specialist should be strictly followed. Only in this way is it possible to continue bearing and give birth to a full-fledged child.

How does a hematoma come out during pregnancy

It happens that a hematoma in the uterus during early pregnancy comes out by itself. This often occurs if the hematoma is located close to the cervix. A sign of the release of the cavity are brownish discharge from the penis. This symptom is often confused with the menstrual cycle and unaware of the onset of pregnancy.

If the hematoma itself is not cleared, then it is brought to this in a therapeutic way. The drugs prescribed by the gynecologist stimulate the filling of the cavity with blood and accelerate clotting. This happens towards the end of the first trimester or at the beginning of the second. How many days will the bleeding last? This is determined by a series of factors:

individual characteristics of the organism,
cavity localization,
education sizes.

During the period of hematoma cleansing, the expectant mother should stay in the hospital. Until the cavity is completely cleared, the threat of pregnancy will not pass.

Prevention

To avoid problems with pregnancy, a woman should be systematically examined by her doctor and listen to his advice. When visiting a gynecologist for the first time about pregnancy, you should truthfully answer all questions - this will help to avoid unnecessary problems. Be sure to take the necessary tests in a timely manner.

Habits and lifestyle play a big role. While carrying a child, you should try to avoid provoking factors, come to the appointment at the specified time, take care of the well-being of the pregnancy. Useful walks in the fresh air. Physical exercise should be viable. It is necessary to pay attention to proper nutrition rich in vitamins and microelements. When any anxiety symptoms you need to consult a specialist immediately.