Subchorionic Hematoma: Causes, Symptoms, and Treatment Options

Subchorionic hematoma (SCH) is a condition that involves the collection of blood between the uterine wall and the placenta during pregnancy. While it may sound concerning, many women with SCH go on to have healthy pregnancies. In this article, we will explore the causes, symptoms, associated risks, treatment options, and when to seek medical attention for subchorionic hematoma.

What is Subchorionic Hematoma?

A subchorionic hematoma occurs when blood accumulates between the chorion (the outer membrane surrounding the embryo) and the uterine wall. This condition is common in early pregnancy and can vary in size. In most cases, subchorionic hematomas resolve on their own without causing harm to the mother or baby, though monitoring is essential to ensure no complications arise.

Causes of Subchorionic Hematoma

Subchorionic hematoma can occur due to several factors, including:

• Placental Abnormalities: Any issues with the placenta, such as improper attachment, can increase the likelihood of a hematoma.
• Implantation Bleeding: When the fertilized egg implants in the uterus, small blood vessels may rupture, leading to bleeding that forms a hematoma.
• Trauma or Injury: Physical trauma, such as a fall or blow to the abdomen, can lead to SCH.
• Increased Blood Flow: Hormonal changes during pregnancy can cause blood vessels to dilate, increasing the chances of blood accumulation.
• Advanced Maternal Age: Women who are older may be more likely to develop SCH due to changes in the placenta and uterine environment.

Associated Symptoms

Many women with subchorionic hematoma may not experience symptoms, but when symptoms do occur, they can include:

• Vaginal Bleeding: This is the most common symptom. The bleeding can range from light spotting to heavier bleeding, similar to a period.
• Abdominal Pain: Some women may experience cramping or dull abdominal pain.
• Back Pain: Mild back pain may also accompany bleeding or cramping in some cases.
• Ultrasound Findings: SCH is often discovered during routine ultrasounds for other pregnancy-related monitoring.

When to Seek Medical Attention

While a subchorionic hematoma may not always require medical intervention, it is important to seek medical attention if:

• The bleeding becomes heavy or is accompanied by clotting.
• You experience severe abdominal pain or cramping that doesn’t subside.
• You notice a sudden decrease in fetal movement after the bleeding starts.
• You have a history of miscarriage or other complications and want to ensure proper monitoring.

Diagnosis of Subchorionic Hematoma

Subchorionic hematomas are typically diagnosed through ultrasound. The procedure helps the healthcare provider assess the size, location, and potential risks associated with the hematoma. If bleeding occurs, your doctor may order follow-up ultrasounds to monitor the hematoma and ensure it is resolving appropriately.

Treatment Options for Subchorionic Hematoma

Treatment for subchorionic hematoma largely depends on the size of the hematoma, its location, and the stage of pregnancy. The options include:

• Rest: Doctors may recommend pelvic rest, which includes avoiding sexual activity and strenuous physical activity, to help reduce the risk of complications.
• Observation: In most cases, small subchorionic hematomas will resolve on their own. Your healthcare provider may suggest monitoring through follow-up ultrasounds.
• Medication: In rare cases, medications to reduce uterine contractions or treat underlying conditions may be prescribed.
• Hospitalization: If the bleeding is heavy, or if there are concerns about preterm labor, hospitalization may be recommended for closer monitoring.

Myths and Facts About Subchorionic Hematoma

Let’s address some common myths about subchorionic hematoma:

• Myth: Subchorionic hematoma always leads to a miscarriage.
• Fact: While SCH can increase the risk of miscarriage, many women with this condition go on to have healthy pregnancies, especially if the hematoma resolves on its own.
• Myth: Resting is not necessary if you have a subchorionic hematoma.
• Fact: Resting can help reduce the strain on the uterus and may prevent complications, but not all cases require complete bed rest.

Complications of Subchorionic Hematoma

In most cases, subchorionic hematoma does not lead to significant complications. However, untreated or severe cases can lead to:

• Miscarriage: While rare, a large hematoma can increase the risk of miscarriage, especially if it causes a significant separation between the placenta and uterine wall.
• Preterm Labor: Heavy bleeding caused by SCH may trigger preterm labor or affect the growth and development of the fetus.
• Placental Abruption: In rare instances, SCH can cause the placenta to detach from the uterine wall, leading to severe complications for both the mother and baby.

FAQs About Subchorionic Hematoma

1. Can subchorionic hematoma affect the baby?

In most cases, subchorionic hematomas do not directly harm the baby. However, large or persistent hematomas can increase the risk of complications like preterm birth or low birth weight. Monitoring and follow-up ultrasounds are essential to ensure fetal health.

2. Can I still exercise if I have a subchorionic hematoma?

If you have a subchorionic hematoma, it is generally recommended to avoid strenuous activities and exercise that could put additional strain on the uterus. Your doctor will advise on when it is safe to resume normal activities based on your condition.

3. How long does it take for a subchorionic hematoma to heal?

The healing time for a subchorionic hematoma varies depending on its size and location. In many cases, small hematomas resolve within a few weeks, while larger ones may take longer to heal. Regular ultrasounds will help your doctor monitor progress.

4. Can a subchorionic hematoma cause miscarriage in early pregnancy?

While there is a risk of miscarriage with subchorionic hematoma, especially in early pregnancy, most women with this condition go on to have a successful pregnancy. Proper monitoring and medical care can help manage the risks associated with SCH.

5. How common is subchorionic hematoma during pregnancy?

Subchorionic hematoma is relatively common, occurring in up to 25% of pregnancies. It is most often diagnosed during the first trimester but can sometimes occur later. Early detection and management are key to ensuring a healthy pregnancy.

Conclusion

Subchorionic hematoma is a common condition that often resolves without causing harm to the mother or baby. With appropriate medical care, monitoring, and rest, many women with this condition can have a healthy pregnancy. If you experience any concerning symptoms or bleeding, it is important to consult your healthcare provider for an accurate diagnosis and personalized treatment plan.