Associations between first-trimester intrauterine hematoma and twin pregnancy outcomes: a retrospective cohort study
Abstract Background In recent years, first-trimester intrauterine hematoma (IUH) has become increasingly common in twin pregnancy. The majority of studies on IUH have excluded twin pregnancies, and others did not differentiate between singleton and twin pregnancies. The impact of IUH on twin pregnan...
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| Format: | Article |
| Language: | English |
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BMC
2021-01-01
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| Series: | BMC Pregnancy and Childbirth |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12884-020-03528-0 |
| _version_ | 1811270805166751744 |
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| author | Wanqing Ji Bo Hou Weidong Li Fang Guo Ping He Jie Zheng |
| author_facet | Wanqing Ji Bo Hou Weidong Li Fang Guo Ping He Jie Zheng |
| author_sort | Wanqing Ji |
| collection | DOAJ |
| description | Abstract Background In recent years, first-trimester intrauterine hematoma (IUH) has become increasingly common in twin pregnancy. The majority of studies on IUH have excluded twin pregnancies, and others did not differentiate between singleton and twin pregnancies. The impact of IUH on twin pregnancy is unclear. Therefore, the primary objective of our study was to examine associations between first-trimester IUH and pregnancy outcomes in twin pregnancies. Methods The data of 1020 twin pregnancies in women who received a routine examination from January 2014 to December 2018 were reviewed. We compared baseline data and pregnancy outcomes between those with and without IUH. Multivariable logistic regression analysis was used to adjust for possible confounding factors. Results A total of 209 patients (21.3%) developed IUH in the first trimester. First-trimester IUH was significantly associated with increased odds of miscarriage (adjusted odds ratio 14.27, 95% CI 8.25–24.70) and vanishing twin syndrome (adjusted odds ratio 3.26, 95% CI 1.11–4.61). However, there were no differences in the rates of stillbirth, preeclampsia, preterm labor (< 34 weeks), low birth weight, postpartum hemorrhage or fetal distress between the two groups. Maternal age, previous preterm birth, chorionicity in twins and the gestational week at first ultrasound did not differ between the two groups. The women with IUH had high rates of previous miscarriage (46.73% vs 38.37%, p = 0.01), assisted conception (48.56% vs 32.60%, p < 0.001) and accompanied vaginal bleeding (67.46% vs 13.43%, p < 0.001). According to the logistic regression analyses, these characteristics were not associated with pregnancy loss or vanishing twin syndrome. No IUH characteristics, including volume, largest diameter, or the presence of vaginal bleeding, were associated with pregnancy loss or vanishing twin syndrome before 20 weeks of gestation (P > 0.05). Conclusion In women with twin pregnancy, the presence of IUH in the first trimester was associated with the loss of one or both fetuses before 20 weeks of gestation. However, previous miscarriage, the conception method, the IUH size and the presence of vaginal bleeding were not independently associated with miscarriage or vanishing twin syndrome. |
| first_indexed | 2024-04-12T22:08:41Z |
| format | Article |
| id | doaj.art-80d40afa1840459cbaaa4a984576ebf1 |
| institution | Directory Open Access Journal |
| issn | 1471-2393 |
| language | English |
| last_indexed | 2024-04-12T22:08:41Z |
| publishDate | 2021-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pregnancy and Childbirth |
| spelling | doaj.art-80d40afa1840459cbaaa4a984576ebf12022-12-22T03:14:50ZengBMCBMC Pregnancy and Childbirth1471-23932021-01-012111810.1186/s12884-020-03528-0Associations between first-trimester intrauterine hematoma and twin pregnancy outcomes: a retrospective cohort studyWanqing Ji0Bo Hou1Weidong Li2Fang Guo3Ping He4Jie Zheng5Department of Obstetrics, Guangzhou Women and Children’s Medical Center, Guangzhou Medical UniversityDepartments of Neurosurgery, The Third Affiliated Hospital, Sun Yat-sen UniversityDepartment of Woman and Child Health Information Guangzhou Women and Children’s Medical Center, Guangzhou Medical UniversityDepartment of Obstetrics, Guangzhou Women and Children’s Medical Center, Guangzhou Medical UniversityDepartment of Obstetrics, Guangzhou Women and Children’s Medical Center, Guangzhou Medical UniversityDepartment of Obstetrics, Guangzhou Women and Children’s Medical Center, Guangzhou Medical UniversityAbstract Background In recent years, first-trimester intrauterine hematoma (IUH) has become increasingly common in twin pregnancy. The majority of studies on IUH have excluded twin pregnancies, and others did not differentiate between singleton and twin pregnancies. The impact of IUH on twin pregnancy is unclear. Therefore, the primary objective of our study was to examine associations between first-trimester IUH and pregnancy outcomes in twin pregnancies. Methods The data of 1020 twin pregnancies in women who received a routine examination from January 2014 to December 2018 were reviewed. We compared baseline data and pregnancy outcomes between those with and without IUH. Multivariable logistic regression analysis was used to adjust for possible confounding factors. Results A total of 209 patients (21.3%) developed IUH in the first trimester. First-trimester IUH was significantly associated with increased odds of miscarriage (adjusted odds ratio 14.27, 95% CI 8.25–24.70) and vanishing twin syndrome (adjusted odds ratio 3.26, 95% CI 1.11–4.61). However, there were no differences in the rates of stillbirth, preeclampsia, preterm labor (< 34 weeks), low birth weight, postpartum hemorrhage or fetal distress between the two groups. Maternal age, previous preterm birth, chorionicity in twins and the gestational week at first ultrasound did not differ between the two groups. The women with IUH had high rates of previous miscarriage (46.73% vs 38.37%, p = 0.01), assisted conception (48.56% vs 32.60%, p < 0.001) and accompanied vaginal bleeding (67.46% vs 13.43%, p < 0.001). According to the logistic regression analyses, these characteristics were not associated with pregnancy loss or vanishing twin syndrome. No IUH characteristics, including volume, largest diameter, or the presence of vaginal bleeding, were associated with pregnancy loss or vanishing twin syndrome before 20 weeks of gestation (P > 0.05). Conclusion In women with twin pregnancy, the presence of IUH in the first trimester was associated with the loss of one or both fetuses before 20 weeks of gestation. However, previous miscarriage, the conception method, the IUH size and the presence of vaginal bleeding were not independently associated with miscarriage or vanishing twin syndrome.https://doi.org/10.1186/s12884-020-03528-0Intrauterine hematomaTwin gestationFirst trimesterMiscarriageVanishing twin syndrome |
| spellingShingle | Wanqing Ji Bo Hou Weidong Li Fang Guo Ping He Jie Zheng Associations between first-trimester intrauterine hematoma and twin pregnancy outcomes: a retrospective cohort study BMC Pregnancy and Childbirth Intrauterine hematoma Twin gestation First trimester Miscarriage Vanishing twin syndrome |
| title | Associations between first-trimester intrauterine hematoma and twin pregnancy outcomes: a retrospective cohort study |
| title_full | Associations between first-trimester intrauterine hematoma and twin pregnancy outcomes: a retrospective cohort study |
| title_fullStr | Associations between first-trimester intrauterine hematoma and twin pregnancy outcomes: a retrospective cohort study |
| title_full_unstemmed | Associations between first-trimester intrauterine hematoma and twin pregnancy outcomes: a retrospective cohort study |
| title_short | Associations between first-trimester intrauterine hematoma and twin pregnancy outcomes: a retrospective cohort study |
| title_sort | associations between first trimester intrauterine hematoma and twin pregnancy outcomes a retrospective cohort study |
| topic | Intrauterine hematoma Twin gestation First trimester Miscarriage Vanishing twin syndrome |
| url | https://doi.org/10.1186/s12884-020-03528-0 |
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