The relationship between first-trimester subchorionic hematoma, cervical length, and preterm birth

Anna Palatnik*, William A. Grobman

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

10 Scopus citations

Abstract

Objective The objective of the study was to evaluate the association between a sonographically diagnosed subchorionic hematoma (SCH) in the first trimester and subsequent midtrimester cervical length and preterm birth. Study Design In this cohort study, 512 women with an SCH on their first-trimester ultrasound were compared with 1024 women without a first-trimester SCH. All women underwent routine transvaginal cervical length measurement between 18 and 22 weeks. Women with multifetal gestation, cerclage, or a uterine anomaly were excluded. A multivariable linear regression was performed to assess the independent association of SCH with cervical length, and a logistic regression was done to determine whether the presence of SCH was associated with preterm birth independent of the cervical length. Results In a univariable analysis, the presence of a SCH was significantly associated with a shorter mean cervical length as well as a cervical length less than the 10th percentile (4.27 cm vs 4.36 cm, P =.038; 1.9% vs 0.5%, P =.006, respectively). Preterm birth also was more common in women with an SCH (12.5% vs 7.3%, P =.001). Even after adjusting for potentially confounding factors, a significant negative association existed between the presence of an SCH and cervical length (centimeters) (linear regression coefficient, -0.08; 95% confidence interval, -0.17 to -0.005). In a multivariable regression, SCH remained associated with preterm birth, even with cervical length entered into the equation as a covariate (adjusted odds ratio, 1.58; 95% confidence interval, 1.09-2.32). Conclusion First-trimester SCH is associated with both a shorter cervical length and preterm birth. Our data suggest, however, that mechanisms other than cervical shortening may be involved in preterm birth among women with SCH.

Original languageEnglish (US)
Pages (from-to)403.e1-403.e4
JournalAmerican journal of obstetrics and gynecology
Volume213
Issue number3
DOIs
StatePublished - Sep 1 2015

Keywords

  • cervical length
  • preterm birth
  • subchorionic hematoma

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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