Retroplacental haemorrhage
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View Jeremy Jones's current disclosures- Retroplacental haematoma
- Retroplacental hemorrhage
- Retroplacental hematoma
Retroplacental haemorrhage occurs when there is perigestational haemorrhage that is confined to the retroplacental space.
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Pathology
This type of haemorrhage occurs behind the placenta. The haematoma, therefore, separates the placenta from the uterine wall. The source of bleeding is probably from spiral arteries.
Aetiology
- in late pregnancy, it is typically caused by a placental abruption
Radiographic features
Ultrasound
Sonographically, a retroplacental haematoma may mimic a thickened placenta because the haematoma is commonly isoechoic to the placenta. It should be suspected if the retroplacental hypoechoic zone is thickened to >2 cm 6. Otherwise, the retroplacental haematoma may be hypoechoic or may be of heterogeneous echogenicity.
Colour Doppler interrogation will reveal the absence of internal blood flow, this finding allows differentiation of haematomas from other placental masses.
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Differential diagnosis
- focal retroplacental myometrial contraction: transient
- causes of placentomegaly: particularly in isoechoic haematoma
- retroplacental uterine leiomyoma: consider in hypoechoic haematoma
References
- 1. Kaakaji Y, Nghiem H, Nodell C, Winter T. Sonography of Obstetric and Gynecologic Emergencies: Part I, Obstetric Emergencies. AJR Am J Roentgenol. 2000;174(3):641-9. doi:10.2214/ajr.174.3.1740641
- 2. Rizzo G, Capponi A, Soregaroli M, Arduini D, Romanini C. Early Fetal Circulation in Pregnancies Complicated by Retroplacental Hematoma. J Clin Ultrasound. 1995;23(9):525-9. doi:10.1002/jcu.1870230904
- 3. Elsayes K, Trout A, Friedkin A et al. Imaging of the Placenta: A Multimodality Pictorial Review. Radiographics. 2009;29(5):1371-91. doi:10.1148/rg.295085242
- 4. Trop I & Levine D. Hemorrhage During Pregnancy: Sonography and MR Imaging. AJR Am J Roentgenol. 2001;176(3):607-15. doi:10.2214/ajr.176.3.1760607
- 5. Carol B. Benson. Ultrasound: A Practical Approach to Clinical Problems. (2000) ISBN: 0865778612
- 6. Kellow Z & Feldstein V. Ultrasound of the Placenta and Umbilical Cord. Ultrasound Quarterly. 2011;27(3):187-97. doi:10.1097/ruq.0b013e318229ffb5
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