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

Abstract

Purpose: We investigated the contribution of subchorionic hematoma (SCH) involvement in early pregnancy to the risk of pregnancy complications in women who underwent frozen-thawed embryo transfer (FET). Methods: A hypoechogenic area surrounding the gestational sac at early pregnancy on ultrasound was defined as SCH. Simultaneously, the presence of vaginal bleeding was evaluated. We included 1416 women with live births after FET between March 2015 and September 2018 in this study. The frequency of pregnancy complications was compared between the SCH (n = 340) and non-SCH (n = 1076) groups. Results: The adjusted odds ratio of abnormal placental adhesion and placenta previa for the SCH group relative to the non-SCH group was 7.01 [2.96-18.00] and 3.77 [1.24-11.91], respectively. In contrast, hypertensive disorders of pregnancy, non-reassuring fetal status, fetal growth restriction, chorioamnionitis, and premature rupture of the membrane showed no differences between both groups. Furthermore, the frequency of abnormal placental adhesion was higher in the SCH group with vaginal bleeding than in the SCH group without vaginal bleeding. Conclusions: Subchorionic hematoma in early pregnancy may cause abnormal placental adhesion and placenta previa in pregnant women with FET. SCH presence should be carefully noted, particularly in cases with vaginal bleeding during early pregnancy after FET.