Bleeding during pregnancy can occur for many different reasons.  One of them is having a subchorionic hematoma or hemorrhage.  This is when bleeding occurs under the membranes that surround the embryo inside the uterus. 

This membrane is called the chorion membrane.  It attaches the mother’s uterine wall to the baby’s amniotic sac.  This is a common cause of vaginal bleeding in the early stage of pregnancy.  It accounts for about 10% of vaginal bleeding during pregnancy in the 10-20 week span. 

Subchorionic hematomas can be small and resolve on their own.  Sometimes there isn’t any visible evidence of a hematoma and they may go undetected until a routine ultrasound.  When the subchorionic hematomas are larger or happen later on in the pregnancy is when they can cause more problems. 

Letting your doctor know immediately if you are bleeding while pregnant is key to getting these diagnosed and come up with a treatment plan. 

 

Causes of Subchorionic Hematoma

The actual cause of a subchorionic hematoma is unclear. 

There are some things that can raise your risk of developing them.  If you have a malformation of your uterus.  History of recurrent miscarriages.  History of pelvic or uterine infections.  Trauma.  Early onset of preeclampsia.  Severe high blood pressure.  In vitro fertilization. 

 

Signs & Symptoms of Subchorionic Hematoma 

There sometimes are no signs or symptoms.  Subchorionic hematomas can be seen during a routine ultrasound.  This is when most people discover they have one.  The most common symptom though is vaginal bleeding.  The severity can differ from light spotting, to heavy with clots depending on the severity of the hematoma.  Another symptom you may experience is cramping.  Though some people don’t experience cramping at all.  

 

Treatment Options for Subchorionic Hematoma

Treatment for a subchorionic hematoma depends on a few things.  It is dependent on how far along you are in your pregnancy, the size of the hematoma and the severity of it.  

If you have a subchorionic hematoma before 20 weeks of pregnancy your treatment will differ than if you are after 20 weeks of pregnancy.  Before 20 weeks your doctor will want you to reduce your activity level.  This may be just slowing down a bit, but could also resolve in full bed rest.  Your doctor may suggest that you limit your travel during this time as well.  Avoid sex.  You may need to be hospitalized if your bleeding, cramping, or signs of early labor occur or continue. 

After 20 weeks your doctor will want to do regular ultrasounds once a month, but possibly more.  This will help them keep an eye on the hematoma and make sure your baby is not in distress.  You will also be taught to know and recognize signs of preterm labor. 

If preterm labor occurs you may need treatment to stop the labor depending on how far along you are in your pregnancy.  You may also need to be hospitalized after 20 weeks if your bleeding occurs after 24 weeks.  

 

Health Surgeon’s Pregnancy Due Date Calculator

 

Outcomes

Most of the time subchorionic hematomas resolve on their own within a few weeks.  The amount of time they take to heal depends on the size of the hematoma and each patient.  Each patient will heal differently. 

There are some complications that can arise with a subchorionic hematoma.  One is that the placenta can become separated from the uterine wall.  This complication can heighten the risk of miscarriage and preterm labor.  

 

Other Causes Of Bleeding While Pregnant

Subchorionic hematomas are not the only cause of bleeding during pregnancy. 

Other causes are miscarriage, ectopic pregnancy, implantation bleeding, bleeding after sex while pregnant, infection, placenta previa, or placenta abruption. 

If you are bleeding while pregnant it is important to tell your doctor as soon as possible.  You can not assume what is causing your bleeding.  The cause can be harmful for you and your baby.  If your symptoms change at any point you will also want to reach out to your doctor.  

 

Takeaway

Most of the time this condition is harmless.  It usually resolves on its own causing little to no discomfort to the mother or baby. Even with this type of hematoma your baby can be born healthy will not adverse effects. 

 

 



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