[Retroplacental hematoma and uterine Doppler scan]

The authors studied uterine Doppler findings in four cases of retroplacental hematoma at 26, 30.5, 31 and 37 weeks of amenorrhea. In all cases, the diastolic index was low, and a diastolic notch was present. In three cases, the hematoma was visualised under ultrasound. The literature on the subject confirms that the velocity of the uterine circulation is always abnormal in retroplacental hematoma. This test is therefore fundamental for the detection of clinically incomplete retroplacental hematomas and for determining the pregnancy prognosis in women with a history of vascular problems. Two of our patients received treatment with acetylsalicylic acid at an early stage of a subsequent pregnancy. The uterine Doppler scans carried out during this pregnancy at the same date as during the pregnancy with retroplacental hematoma revealed normal bloodflow velocity. The infants were born at term with normal weight. Uterine Doppler ultrasound is, therefore, an essential prognosis factor for these high-risk patients. In addition, routine performance of a uterine Doppler scan at about 22 weeks of amenorrhea in women in their first pregnancy could be useful, as any abnormal finding might be the indication for preventive treatment with acetylsalicylic acid.