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Tuesday, July 16, 2024

What does a hematoma mean in pregnancy?

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One of the main concerns in both spontaneous and medically assisted pregnancies is the presence of bruising or clots near the amniotic sac.

In practical terms we can divide them into recent and old bruises. As its name indicates, the recent ones are clots that appear as a result of bleeding that occurs in the early stages of pregnancy, the typical story is a previously healthy patient, who begins to have bleeding, goes to the obstetrician, an ultrasound is performed and the presence of a clot is observed, the dangerousness of this finding is determined by two things: first by the gestational age (pregnancies less than 12 weeks are more likely to be lost) and the size of the hematoma (hematomas greater than 50% in relation to the amniotic sac have a worse prognosis). The treatment is based on absolute rest, assessing the opening of the cervix and the use of medications such as progesterone, indomethacin. In any case, your GP will tell you which is the most appropriate treatment for your situation.

Old hematomas, on the other hand, are generally incidental findings, that is, the patient has no history of bleeding or pain and attends a prenatal control ultrasound and is referred to the presence of the hematoma. They are generally self-limited and are due to the rupture of an endometrial vessel that, because it did not cause bleeding through the vagina, went unnoticed. These old bruises may resorb (ie, disappear on subsequent ultrasound checks) or initiate mild, mild dark bleeding. As in the previous case, the treating doctor will carry out the assessments and will explain what is the best measure for your pregnancy at that time.

Under no circumstances is a hematoma the same as a curettage, curettage is performed under two circumstances only: the presence of uncontrollable bleeding that endangers the life of the patient (for example, fainting, changing more than 4 sanitary napkins with abundant blood in a couple of hours, etc.) or in the absence of a fetal heartbeat. In early pregnancies, medication can be used to expel the sac (with the embryo already deceased), but each clinical situation and each particular context must be assessed. We hope this information is useful, and as we have discussed in previous posts, tag whoever needs it and share this information in your stories to create a community of support for women!

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