Risk of Placenta Accreta Spectrum With Early Pregnancy Subchorionic Hematoma Location and Size in Hormone Replacement Cycles
Year: 2025
Type: article
Study design: Observational Study
Abstract: Purpose: To study whether subchorionic hematoma (SCH) location and size in early pregnancy affect placenta accreta spectrum (PAS) risk in hormone replacement cycles (HRC). Methods: Retrospective cohort study of 685 singleton live births following frozen-thawed embryo transfer in HRC (November 2018-September 2023) at a single fertility clinic. SCH location (cervical-side, mid-cavity, or fundal-side) and size (< 10% or > 50% of gestational sac), assessed by first-trimester ultrasound, were evaluated for association with PAS. Results: The presence of SCH showed a trend toward increased PAS frequency (adjusted Risk Ratio (RR) 1.56, 95% Confidence Interval (CI) 0.87-2.80). Location-specific analysis revealed that cervical-side SCH conferred significantly elevated PAS risk compared to those without cervical-side SCH (adjusted RR 2.21, 95% CI 1.18-4.15), whereas mid-cavity SCH (adjusted RR 1.74, 95% CI 0.94-3.22) and fundal-side SCH (adjusted RR 0.59, 95% CI 0.20-1.76) showed no significant association. Regarding SCH size, larger hematomas (> 50% of gestational sac) were not associated with increased PAS risk compared to smaller hematomas (< 10%) (adjusted RR 0.59, 95% CI 0.16-2.13). Conclusions: Cervical-side SCH, but not mid-cavity or fundal-side hematomas, was associated with increased PAS risk in HRC pregnancies. These findings suggest that SCH location may serve as a key prognostic marker in HRC.
DOI: 10.1002/rmb2.70005
Institution: Hamamatsu University School of Medicine
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $1,850
OpenAlex ID: W7117131870