Perigestational hemorrhage refers to hemorrhage that occurs around the fetus during the gestational period. The spectrum of hemorrhage includes:
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chorionic hemorrhage: caused by the separation of the chorion from the endometrium
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subchorionic hemorrhage: most common type, occurs between the chorion and endometrium
Breus mole: very large subchorionic hemorrhage
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periplacental hematoma
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Epidemiology
2% of pregnancies <10 weeks
20% of those have vaginal bleeding <10 weeks
Pathology
Venous bleeding from the chorionic plate.
Treatment and prognosis
>90% pregnancy success rate if living embryo with small perigestational hemorrhage
large perigestational hemorrhage (>50% of gestational sac circumference): 25% loss rate even if living embryo
perigestational hemorrhage with embryonic bradycardia (≤90 beats per minute): 80% loss rate
it is a weak predictor of failing pregnancy
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