Risk Stratification Based on Imaging Findings for Pregnancies With Subamniotic or Subchorionic Hematoma on Placental...

Area of Science:

• Obstetrics and Gynecology
• Radiology
• Neonatal Medicine

Background:

• Subamniotic or subchorionic hematoma (SAH/SCH) is linked to varied pregnancy outcomes.
• The impact of oligohydramnios and hemorrhagic amniotic fluid on MRI in SAH/SCH pregnancies is not well-defined.

Purpose of the Study:

• To assess the significance of oligohydramnios and hemorrhagic amniotic fluid detected via placental MRI in risk stratifying SAH/SCH pregnancies.
• To correlate MRI findings with obstetric and neonatal outcomes.

Main Methods:

• Retrospective study of 71 singleton pregnancies with SAH/SCH identified on MRI (second or third trimester).
• Pregnancies were categorized based on MRI findings: oligohydramnios and/or hemorrhagic amniotic fluid.
• Outcomes analyzed included abortion, preterm birth (<34 weeks), and neonatal intensive care unit (NICU) stay duration.

Main Results:

• Group A (oligohydramnios and hemorrhagic amniotic fluid) had significantly higher unfavorable obstetric outcomes (91.7%) compared to Group B (35.3%) and Group C (21.4%).
• Group A also exhibited the longest median NICU stay (87 days), indicating the worst neonatal outcomes.
• Significant differences in outcomes were observed across subclassified groups, particularly between isolated oligohydramnios and isolated hemorrhagic amniotic fluid.

Conclusions:

• MRI-detected oligohydramnios and/or hemorrhagic amniotic fluid in SAH/SCH pregnancies are associated with adverse obstetric and neonatal outcomes.
• These imaging findings are valuable for improving risk stratification in pregnancies complicated by SAH/SCH.
• Placental MRI plays a crucial role in identifying high-risk pregnancies with SAH/SCH.