Subchorionic Hematoma

subchorionic hematoma is a gathering of blood between the outer wall of the embryo (chorion) and the inner wall of the womb (uterus).

This condition can cause vaginal bleeding. If they cause little or no vaginal bleeding, early small hematomas usually shrink on their own and do not affect your baby or pregnancy. When bleeding starts later in pregnancy, or if the hematoma is larger or occurs in older pregnant women, the condition may be more serious. Larger hematomas may get bigger, which increases the chances of miscarriage. This condition also increases the risk of:

• Premature separation of the placenta from the uterus.
• Premature (preterm) labor.
• Stillbirth.

What are the causes?

The exact cause of this condition is not known. It occurs when blood is trapped between the placenta and the uterine wall because the placenta has separated from the original site of implantation.

What increases the risk?

You are more likely to develop this condition if:

• You were treated with fertility medicines.
• You conceived through in vitro fertilization (IVF).

What are the signs or symptoms?

Symptoms of this condition include:

• Vaginal spotting or bleeding.
• Contractions of the uterus. These cause abdominal pain.

Sometimes you may have no symptoms and the bleeding may only be seen when ultrasound images are taken (transvaginal ultrasound).

How is this diagnosed?

This condition is diagnosed based on a physical exam. This includes a pelvic exam. You may also have other tests, including:

• Blood tests.
• Urine tests.
• Ultrasound of the abdomen.

How is this treated?

Treatment for this condition can vary. Treatment may include:

• Watchful waiting. You will be monitored closely for any changes in bleeding. During this stage:
  • The hematoma may be reabsorbed by the body.
  • The hematoma may separate the fluid-filled space containing the embryo (gestational sac) from the wall of the womb (endometrium).
• Medicines.
• Activity restriction. This may be needed until the bleeding stops.

Follow these instructions at home:

• Stay on bed rest if told to do so by your health care provider.
• Do not lift anything that is heavier than 10 lbs. (4.5 kg) or as told by your health care provider.
• Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. If you need help quitting, ask your health care provider.
• Track and write down the number of pads you use each day and how soaked (saturated) they are.
• Do not use tampons.
• Keep all follow-up visits as told by your health care provider. This is important. Your health care provider may ask you to have follow-up blood tests or ultrasound tests or both.

Contact a health care provider if:

• You have any vaginal bleeding.
• You have a fever.

Get help right away if:

• You have severe cramps in your stomach, back, abdomen, or pelvis.
• You pass large clots or tissue. Save any tissue for your health care provider to look at.
• You have more vaginal bleeding, and you faint or become lightheaded or weak.

Summary

• A subchorionic hematoma is a gathering of blood between the outer wall of the placenta and the uterus.
• This condition can cause vaginal bleeding.
• Sometimes you may have no symptoms and the bleeding may only be seen when ultrasound images are taken.
• Treatment may include watchful waiting, medicines, or activity restriction.