Uterine Artery Hemodynamic Variations among TCM Syndrome Types in Early‐Gestation Subchorionic Hematoma
DOI:
https://doi.org/10.70088/a5ammb71Keywords:
early‐gestation subchorionic hematoma, TCM syndrome pattern, uterine artery hemodynamic index, clinical correlationAbstract
Subchorionic hematoma (SCH) is a frequent first‐trimester obstetric complication marked by separation between chorionic membrane and uterine wall, with blood pooling surrounding the gestational sac within 12 gestational weeks. Clinical manifestations include abdominal discomfort. Severe cases may result in threatened miscarriage, inevitable abortion or embryonic arrest, endangering maternal‐fetal safety. Ultrasound‐derived uterine artery hemodynamic indices serve as objective measurements for uteroplacental circulation and are widely adopted for SCH risk evaluation and prognostic assessment. In traditional Chinese medicine (TCM), SCH corresponds to Tailou and Dongtai Bu'an. Its pathogenesis is closely linked to kidney deficiency, qi‐blood insufficiency and heat‐blood patterns, each presenting distinct pathological mechanisms and clinical features. This review summarizes recent domestic and international literature, covering TCM differentiation rules for SCH, clinical utility of uterine artery hemodynamic indicators, correlations between TCM patterns and hemodynamic profiles, and underlying mechanisms. It aims to offer clinical references for integrated Chinese‐Western management and support individualized, precise management for SCH.References
Y. T. Liu and Y. Y. Liu, "Clinical effect of low-molecular-weight heparin in patients with subchorionic hematoma," Journal of Practical Gynecologic Endocrinology (Electronic Edition), vol. 10, no. 14, pp. 75–77, 2023.
L. L. Sun, "Efficacy of self-formulated Yi-qi Yang-xue Hu-tai Decoction combined with progesterone injection for early threatened abortion complicated with subchorionic hematoma of qi-blood-deficiency syndrome and its influence on β-hCG," Sichuan Journal of Traditional Chinese Medicine, vol. 40, no. 9, pp. 151–154, 2022.
C. F. Zhang, F. Wang, F. X. Mou, et al., "Research progress on immune factors and subchorionic hematoma," Chinese Journal of Family Planning & Obstetrics and Gynecology, vol. 15, no. 3, pp. 32–36, 2023.
M. Pagan, J. Monson, R. Strebeck, et al., "Subchorionic Hemorrhage in the Second and Third Trimesters of Pregnancy: A Review," Obstetrical & Gynecological Survey, vol. 77, no. 12, pp. 745–752, 2022.
W. Lu, H. H. Liu, W. H. Yang, et al., "Predictive value of uterine artery blood-flow parameters for pregnancy outcomes in patients with recurrent miscarriage in early pregnancy," Hebei Medical Journal, vol. 27, no. 4, pp. 579–583, 2021.
X. Y. Zhang, "Clinical observation on tonifying-kidney-and-activating-blood therapy for early threatened abortion with subchorionic hematoma," M.S. thesis, Shandong University of Traditional Chinese Medicine, 2020.
H. T. Heller, E. A. Asch, S. M. Durfee, et al., "Subchorionic Hematoma: Correlation of Grading Techniques With First-Trimester Pregnancy Outcome," Journal of Ultrasound in Medicine, vol. 37, no. 7, pp. 1725–1732, 2018.
C. P. Bondick, J. M. Das, and H. Fertel, "Subchorionic Hemorrhage," in StatPearls, Treasure Island, FL: StatPearls Publishing, 2025.
L. P. Zhang and J. Q. Ma, "Therapeutic effect of Zishen Yutai Pills combined with drotaverine hydrochloride tablets on subchorionic hematoma," World Journal of Traditional Chinese Medicine, vol. 19, no. 14, pp. 2156–2159, 2024.
X. J. Wang, J. Jiao, X. T. Ma, et al., "Analysis of high-risk factors for preterm birth and miscarriage in patients with subchorionic hematoma," Chinese Journal of Practical Gynecology and Obstetrics, vol. 39, no. 12, pp. 1237–1240, 2023.
L. Y. Zhang, Y. S. Du, and J. P. Li, "Risk-factor analysis of subchorionic hematoma in early pregnancy among patients with recurrent spontaneous abortion," Chinese Journal of Practical Gynecology and Obstetrics, vol. 38, no. 10, pp. 1013–1015, 2022.
M. K. Ten Kate and J. van der Meer, "Protein S deficiency: a clinical perspective," Haemophilia, vol. 14, no. 6, pp. 1222–1228, 2008.
Q. Q. Ke and A. M. Zhao, "Research progress on etiology of subchorionic hematoma," Chinese Journal of Practical Gynecology and Obstetrics, vol. 41, no. 2, pp. 252–256, 2025.
Y. Li, E. Wang, and S. Huang, "Autoantibodies in association with subchorionic haematoma in early pregnancy," Annals of Medicine, vol. 53, no. 1, pp. 841–847, 2021.
Y. Lu, C. Chen, and S. S. Peng, "Balance of Th1/Th2 cytokines in patients with threatened abortion complicated with subchorionic hematoma," China Practical Medicine, vol. 13, no. 26, pp. 13–15, 2018.
K. Asato, K. Mekaru, and C. Heshiki, "Subchorionic hematoma occurs more frequently in in vitro fertilization pregnancy," European Journal of Obstetrics, Gynecology, and Reproductive Biology, vol. 181, pp. 41–44, 2014.
B. T. West, P. K. Kavoussi, and K. C. Odenwald, "Factors associated with subchorionic hematoma formation in pregnancies achieved via assisted reproductive technologies," Journal of Assisted Reproduction and Genetics, vol. 37, no. 2, pp. 405–414, 2020.
J. Reich, J. K. Blakemore, and J. A. Grifo, "Comparison of subchorionic hematoma in medicated or natural single euploid frozen embryo transfer cycles," Fertility and Sterility, vol. 114, no. 3, pp. 595–600, 2020.
B. Y. Zhang, Y. Y. Chen, and Y. Hu, "Relationship between subchorionic hematoma in early pregnancy and lower genital tract infection," Journal of Practical Medicine, vol. 39, no. 4, pp. 451–455, 2023.
J. Gu, J. Yuan, and J. P. Wang, "Correlation between serum procalcitonin in preterm infants and the severity of chorioamnionitis," Chinese Journal of Practical Pediatrics, vol. 37, no. 11, pp. 840–845, 2022.
Y. Wang, Z. L. Wei, and Y. X. Cao, "Analysis of oxidative-stress levels in intrauterine hematoma after IVF-ET in early pregnancy," Acta Universitatis Medicinalis Anhui, vol. 51, no. 8, pp. 1164–1167, 2016.
R. N. Guo and Y. L. Wang, "Research progress on etiology of subchorionic hematoma," Hainan Medical Journal, vol. 31, no. 16, pp. 2141–2143, 2020.
X. Yan, H. Xu, and J. Li, "Subchorionic hematoma and risk of preterm delivery: a systematic review and meta-analysis," American Journal of Obstetrics & Gynecology MFM, vol. 5, no. 1, p. 100791, 2023.
S. L. Wang and L. Zhu, "Clinical experience of Lingnan-Luoshi Gynecology in treating threatened abortion combined with subchorionic hematoma," Modern Clinical Journal of Traditional Chinese Medicine, vol. 26, no. 1, pp. 62–65, 2019.
H. B. Ma and K. Q. Li, "Professor Li Ke-qin's experience in treating threatened abortion complicated with subchorionic hematoma," World Journal of Integrated Traditional and Western Medicine, vol. 9, no. 6, pp. 589–591, 2014.
T. X. Chen and J. L. Kuang, "Professor Kuang Ji-lin's experience in treating threatened abortion combined with subchorionic hematoma," Hunan Journal of Traditional Chinese Medicine, vol. 36, no. 10, pp. 21–22, 2020.
J. Y. Guo and Z. C. Jin, "Application experience of blood-activating tocolysis in threatened abortion combined with subchorionic hematoma," World Latest Medicine Information, vol. 19, no. 93, pp. 276–277, 2019.
Y. L. Liu, Y. Ning, and H. Teng, "Director Wang Jun-ling's experience of modified Jiao-ai Decoction for early threatened abortion combined with subchorionic hematoma," China Medical Herald, vol. 17, no. 29, pp. 139–142, 2020.
C. Shu, Y. F. Liu, and F. H. Jin, "Liu Yan-feng's treatment experience for threatened abortion combined with subchorionic hematoma based on 'triple-essence insufficiency, stasis secondary to deficiency'," Modern Journal of Integrated Traditional Chinese and Western Medicine, vol. 34, no. 5, pp. 648–651, 2025.
L. Sun and Z. F. Zheng, "Research progress of traditional Chinese medicine in diagnosis and treatment of subchorionic hematoma," Clinical Journal of Chinese Medicine, vol. 15, no. 24, pp. 17–21, 2023.
W. J. Shao and J. Q. Cui, "Uterine-artery blood-flow parameters, serum IL-6 and IFN-γ and their correlations with pregnancy outcomes in patients with recurrent miscarriage," Henan Medical Research, vol. 33, no. 4, pp. 675–679, 2024.
Y. Y. Rao and M. Chen, "Detection value of first-trimester uterine-artery hemodynamic parameters, serum homocysteine and D-dimer in recurrent miscarriage," China Modern Doctor, vol. 62, no. 18, pp. 26–29, 2024.
X. M. Wang, J. X. Xu, and X. Li, "First-trimester uterine-artery blood-flow parameters combined with D-dimer for evaluating adverse pregnancy outcomes in women with recurrent miscarriage," Journal of Molecular Imaging, vol. 47, no. 12, pp. 1393–1398, 2024.
Y. Zhang, "Efficacy of bilateral uterine-artery hemodynamic parameters and early-diastolic notches in evaluating adverse pregnancy outcomes among patients with recurrent miscarriage in early gestation," Chinese Journal of New Clinical Medicine, vol. 15, no. 9, pp. 858–861, 2022.
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Lin Yan, Lihong Zhu (Author)
This work is licensed under a Creative Commons Attribution 4.0 International License.
