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Subchorionic Hematoma associated with Preeclampsia and Fetal Distress: Case Report

This paper is available in a repository.
This paper is available in a repository.

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Abstract

Objective: In this case report; we present a patient of 26 weeks pregnancy with a prominent subchorionic hematoma and discuss the differential diagnosis of placental masses with respect to the related literature. Case: Twenty years old, 26 weeks pregnant patient, referred to our clinic with the presumptive diagnosis of PPROM (preterm pre-matrue rupture of the membranes), ablatio placentae and IUGR (intrauterine growth restriction) was evaluated. Doppler ultrasonog-raphy revealed; a hypoechoic mass lesion with a diameter of 5 cm in the placenta compatible with hematoma. The diagnosis sub-chorionic hematoma, was established by means of 3D sonography and clinical findings. Worsening of fetal and maternal wellbeing led to the early delivery. Histopathological examination of the placenta verified the subchorionic hematoma. Conclusion: Differential diagnosis of subchorionic hematoma from ablatio placenta and chorioangioma should be made, because of the differences in the clinical followup and management. Doppler, 3D sonography and MRI are the main diagnostic tools. Worsening of the fetal or maternal wellbeing should prompt immediate delivery. Amaç: 26. gebelik haftas›nda genifl subkoryonik hematom olgusunu ve plasental kitlelere tan›sal ve klinik yaklafl›mla ilgili literatür bil-gisi sunmak. Olgu: Ablasyo plasenta, erken membran rüptürü ve geliflme k›s›tlanmas› ön tan›lar›yla refere edilen 20 yafl›nda SAT 'e göre 26 hafta G1P0 olgu de¤erlendirildi. Yap›lan Doppler ultrasonografide plasenta içinde 5 cm çap›nda hipoekoik hematom ile uyumlu kitlede kan ak›m› tespit edilmedi. Üç boyutlu ultrasonografi ve klinik bulgularla Subkoryonik Hematom tan›s› kondu. Fetal ve maternal durumda kötüleflme nedeniyle gebelik 27. haftada sonland›r›ld›. Do¤um sonras› tan› plasentan›n patolojik incelemesiyle do¤ruland›. Sonuç: Subkoryonik hematoman›n klinik izlem ve tedavide farkl›l›klar göstermesi nedeniyle Ablasyo plasenta ve koryoanjiomadan ay›-r›c› tan›s› mutlaka yap›lmal›d›r. Doppler ve üç boyutlu ultrasonografi ve MRG tan›ya ulaflmada önemlidir. Subkoryonik hematom olgu-lar›nda fatal distres ve maternal durumda kötüleflme söz konusu oldu¤unda do¤um gerçeklefltirilmelidir.