Consult - Retroplacental hematoma

Patient

Q: Dear Doctors: I'm from Argentina and I'm 33 years old. I'm pregnant in the 7th month. I want to know how the diagnosis of a retroplacental hematoma is. I suddenly began to feel abdominal pain. Can a retroplacental hematoma be seen in an ultrasound equipment in about three or four hours from that episode?. What does "ecogenic" mean?. Please, all the information you could send to me would be very useful. I'm looking forward to hearing from you soon and thank you in advance. Cecilia.

Doctor

A:   This is a collection of blood found between the uterine wall and the chorionic membrane and may leak through the cervical canal. This is also the most common sonographic abnormality in the presence of a live embryo. This condition is important in a symptomatic woman because pregnant women with a demonstrable hematoma have a prognosis worse than women without a hematoma especially if the size increases. Large hematomas could separate the placenta form the uterine wall causing miscarriage.
However let me reassure you that most retroplacental hematomas often regress on their own and won’t cause pregnancy complications. Certainly follow up with frequent ultrasounds would be required. I wish you the best.

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