Maternal and perinatal outcomes in women with first-trimester subchorionic hematoma: A prospective case-control study

Background: Subchorionic Hematoma (SCH) is frequently identified on early pregnancy ultrasound, particularly in women presenting with vaginal bleeding. Although often considered a transient and benign finding, concerns persist regarding its possible relationship with adverse obstetric and neonatal outcomes. The prognostic significance of hematoma size remains uncertain. Methods: This prospective case-control study was conducted over one year at a tertiary care center in Jammu, India. A total of 166 pregnant women between 6 and 14 weeks of gestation were enrolled. Eighty-three women with sonographically confirmed SCH constituted the case group, and 83 women without hematoma served as controls. Participants were followed until delivery. Maternal complications and neonatal outcomes were recorded. The relationship between hematoma volume and pregnancy outcome was analyzed. Results: Adverse pregnancy outcomes were observed more frequently among women with SCH compared to controls (37.3% vs 24.1%, p=0.027). Miscarriage (19.3% vs 14.5%), preterm delivery (16.9% vs 9.6%), pregnancy-induced hypertension (8.4% vs 4.8%), placental abruption (6.0% vs 0%), and intrauterine growth restriction (4.8% vs 0%) occurred more often in the SCH group. Mean birth weight was significantly lower in neonates born to mothers with SCH (2733±603 g vs 2969±409 g; p=0.008). Increasing hematoma volume demonstrated a strong association with unfavorable fetal outcomes (p