Massive pre-placental and subchorionic haematoma

Loi K, Tan KT
Correspondence: Dr Kelly Loi, kelly_loi@hotmail.com

ABSTRACT
We report an unusual case of massive pre-placental and subchorionic haematoma occurring in a 26-year-old woman who presented with antepartum haemorrhage at 24 weeks gestation. Ultrasonography showed a subchorionic haematoma in the lower posterior uterine wall measuring 5.0 cm in largest diameter. There was also a separate irregular multiloculated structure measuring 4.3 cm in largest diameter on the surface of the placenta, due to a pre-placental haematoma. The subchorionic haematoma diminished in size over time, while the pre-placental haematoma continued to grow, measuring 9.0 cm at 28 weeks, and 9.3 cm at 32 weeks. At 32 weeks, the patient presented with premature rupture of membranes and four days later, an emergency caesarean section was performed when the patient had another episode of severe antepartum haemorrhage. Both mother and child recovered well. The current literature on such haematomas is reviewed.

Keywords: antepartum haemorrhage, placenta diseases, pre-placental haematoma, pregnancy complications, subchorionic haematoma, ultrasonography
Singapore Med J 2006; 47(12): 1084-1086