Adverse outcome complicated with massive subchorionic hematoma following in vitro fertilization

MIYAMOTO Mayuko, FUKUDA Aya, FUKUDA Hirotsugu, FUKUOKA Hiroko, YOKOI Eriko, OHYAGI Chifumi, TSUBOUCHI Hiroaki, TSUTSUI Tateki

doi:10.11437/sanpunosinpo.67.388

[Case] 32-year-old woman presented with vaginal bleeding at 8 weeks of gestation after frozen embryo transfer. She had an obstetric history of two intrauterine curettages, one for a missed abortion and the other for elective termination of early pregnancy. Her last pregnancy was ectopic and treated with laparoscopic unilateral tubal resection. Ultrasonography revealed a massive subchorionic hematoma, which did not show a decrease in size on follow-up examinations. This patient complained intermittent bleeding, which resulted in severe anemia. She underwent expectant management during hospitalization, but she experienced heavy vaginal bleeding at 20 weeks’ gestation, which resulted in termination to maintain her health. The heavy vaginal bleeding recurred during cervical dilation, and resuscitation for hypovolemic shock was necessary. She also underwent curettage after birth owing to a partially retained placenta and continuous postpartum bleeding. The total blood loss volume during the pregnancy termination and the curettage procedure was approximately 3000 ml, which required a transfusion of 12 units of packed red blood cells and 4 units of fresh frozen plasma. [Conclusion] We reported an adverse obstetric outcome complicated with massive subchorionic hematoma. We discussed the underlying factors, which might be associated with the adverse outcome in this case. [Adv Obstet Gynecol, 67(4) : 388-393, 2015 (H27.10)]

Adverse outcome complicated with massive subchorionic hematoma following in vitro fertilization

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