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2010-12-29-13 Subamniotic bleeding and hematoma © Cuillier www.TheFetus.net
Subamniotic bleeding and hematoma


Fabrice Cuillier, MD., Y. Rio, MD.

Service de Gynécologie-Obstétrique, Hôpital Félix Guyon, Saint-Denis de La Réunion, France.


Case report

A 30-year-old healthy woman, G2 P1, was referred for the ultrasound examination at 38 weeks of gestation. The first and the second trimester scan performed at 12 and 22 weeks showed a normal fetus and normal placenta.
The ultrasound examination at 32 weeks of gestation showed a subamniotic hemorrhage with an abnormal tumor located within the hemorrhage. The fetus was doing fine and the ultrasound exam did not show any abnormalities. The placenta was located on the anterior side, the amount of the amniotic fluid volume was normal. Our differential diagnosis included:
  • the intraamniotic hematoma inside the subamniotic hemorrhage;
  • chorioangioma;
  • submucous myoma;
  • umbilical cord cyst, (which was ruled out, because the cyst was not connected to the umbilical cord).
  • Cytotrophoblastic cysts was ruled out also, because there was not any connection with the placenta. 
At 39 weeks of gestation, the ultrasound showed a cystic structure protruding into the amniotic cavity, and the structure was located underneath the amniotic membrane.
Patient delivered at term without any complications. The diagnosis of the subamniotic hemorrhage was confirmed postnatally.   

Images 1,2: 33 weeks, placenta with subamniotic bleeding, note the round coagulum located inside the hemorrhage.



Images 3,4: Image 3 shows a 3D-image of the hemorrhage and hematoma. Image 4 shows the hemorrhage located between the placenta and amnion.
 


Images 5,6: Images showing subamniotic bleeding and it's relation to the umbilical cord insertion.




Image 7,8: 39 weeks, images show coagulum located within the previous subamniotic hemorrhage.



Images 9: 3D-image of the hematoma protruding into the amniotic cavity.
 


Image 10
: Image of the placenta after delivery, note the hematoma covered with the amniotic membrane.  

 



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