Impact of Subchorionic Hematoma on Pregnancy Outcomes in Obstetric Antiphospholipid Syndrome.

Objective: This study aimed to investigate the effects of subchorionic hematoma (SCH) in patients with obstetric antiphospholipid syndrome (OAPS) on pregnancy outcomes, as well as the clinical value of anticoagulant therapy.

Methods: This retrospective study included 109 OAPS patients treated at the Fourth Hospital of Shijiazhuang from December 2019 to December 2021. Patients were divided into two groups: SCH group (n=40) and non-SCH group (n=69). Baseline data, laboratory indicators (anti-β2GP I, lupus anticoagulant, ACL, D-D, AA, ADP, ATIII, PS, and PC), complications, and pregnancy outcomes were compared between the groups.

Results: There were no significant differences between the two groups concerning the abortion rate, live birth rate (all P>0.05). However, we reported a significantly higher rate of preterm delivery occurring between 34-37 in the SCH group (13.7% vs 1.7%, P=0.027). The proportion of patients with triple-positive antiphospholipid antibodies (aPLs) was significantly higher in the SCH group compared to the non-SCH group (7.5% vs 0.0%, P=0.047). During pregnancy but before routine first-trimester therapy was initiated, the levels of β2GP I, LA, ACL, D-D, AA, and ADP in the SCH group were higher than those in the non-SCH group, while ATIII, PS, and PC levels were lower (all P < 0.05). After treatment, the levels of β2GP I, LA, ACL, D-D, AA, and ADP decreased in both groups compared to their pre-treatment levels (all P < 0.05); however, the levels of D-D and PS in the SCH group remained higher than those in the non-SCH group (all P < 0.05).

Conclusion: In patients with OAPS who present with SCH during pregnancy, laboratory indicators suggest more severe immune disorders and coagulopathy, as well as an increased risk of preterm delivery.