Subcortical hemorrhage is a common complication in early pregnancy that can lead to bleeding or spotting. Treatment options vary depending on the size of the bleed, pregnancy, and doctor’s experience. Most pregnancies with subcortical hemorrhage proceed normally, but there is a slightly elevated risk of miscarriage and placental abruption. If the bleeding results in termination of the pregnancy, counseling services are available, and patients can try again after several months. Emergency delivery may be necessary in cases of placental abruption.
A subcortical hemorrhage is bleeding between the placenta and the wall of the uterus, usually in the first trimester of pregnancy. This is an extremely common complication of pregnancy and sometimes goes unnoticed. In cases where patients experience symptoms and seek medical attention for treatment, the options for managing this condition vary. There is a slightly elevated risk of miscarriage with this complication, and patients may also develop placental abruption, in which the placenta tears away from the uterine wall, posing a serious risk to the pregnancy.
The reasons why subchorionic hemorrhages develop are not immediately apparent. They don’t appear to be strongly tied to any particular behaviors, although activities such as smoking can increase the risk of complications if such bleeds develop. Usually, patients notice subcortical hemorrhage because they experience bleeding or spotting during pregnancy. A doctor can conduct an ultrasound and locate the characteristic dark blood clot outside the placenta.
Depending on the size of the bleed, your pregnancy, and your doctor’s experience with patients, your treatment options can vary widely. Some doctors tell their patients to continue normal activity levels because they have reasonably healthy pregnancies. Others may recommend bed rest until the bleeding clears up and the body reabsorbs the blood. Anticoagulant medications to break up the blood clot more quickly may also be an option with subchorionics. In all cases, the patient should have a follow-up visit to see if the bleeding is resolving or growing and to check for complications.
Many pregnancies with subcortical hemorrhage proceed normally, as the bleeding will eventually resolve on its own, although it may take several weeks. Having such a bleed doesn’t necessarily increase your risks of becoming pregnant, unless it gets bigger or clears up within a reasonable amount of time. An obstetrician can monitor the patient to see how they are doing and detect complications as early as possible in order to provide interventions in a timely manner.
If a subcortical hemorrhage results in the termination of the pregnancy, the doctor can provide treatment and referrals to counseling services. Patients usually have to wait several months after the termination of the pregnancy to try again and are not at increased risk of another miscarriage if they have lost a pregnancy due to the bleeding. In cases where the bleeding causes placental abruption, an emergency delivery may be the best treatment option to save the pregnancy.
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