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Updated: Feb 15, 2026
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Mouse Model of Surgical Uterine Injury and Subsequent Pregnancy Outcomes
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Subchorionic Hematoma: Correlation of Grading Techniques With First-Trimester Pregnancy Outcome
Howard T Heller1, Elizabeth A Asch1, Sara M Durfee1
1Departments of Radiology, Obstetrics and Gynecology , Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Summary
Subchorionic hematoma (SCH) size, measured as a fraction of the gestational sac, best predicts early pregnancy loss. Detecting SCH earlier in pregnancy is linked to a higher risk of pregnancy failure.
Area of Science:
- Obstetrics and Gynecology
- Medical Imaging
- Reproductive Medicine
Background:
- Subchorionic hematomas (SCH) are common in early pregnancy.
- Accurate grading systems are needed to predict pregnancy outcomes.
Purpose of the Study:
- To compare different ultrasound grading systems for SCH.
- To determine which grading system best correlates with first-trimester pregnancy outcome.
- To assess the impact of gestational age at diagnosis on outcome.
Main Methods:
- Retrospective review of 434 first-trimester ultrasound examinations (6-11 weeks) with live embryos and SCH.
- Hematomas graded subjectively (size, percentage of sac), by fraction of gestational sac size, and by 3D measurements.
- Outcomes categorized as live birth or demise.
Main Results:
- Overall first-trimester pregnancy failure rate was 12.0%.
- SCH detected at or before 7 weeks had a significantly higher demise rate (19.6%) compared to those detected after 8 weeks (3.6%).
- Hematoma size relative to gestational sac size strongly correlated with pregnancy loss (P<.001).
Conclusions:
- Subjective assessment of SCH size as a fraction of the gestational sac is the most effective predictor of first-trimester pregnancy outcome.
- Earlier detection of SCH is associated with increased risk of pregnancy failure.
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