A subchorionic hematoma is when blood enters and clots between the placenta and uterine wall during pregnancy. Small ones usually don’t cause symptoms, but large ones can cause abdominal pain and bleeding. The cause is not fully understood, but it is usually diagnosed with an ultrasound. Rest, monitoring, and medication can help reduce complications.
A subchorionic hematoma is a fairly common pregnancy complication that involves blood entering and clotting in the space between the placenta and the uterine wall. Bleeding occurs when part of the placenta breaks away from the surrounding endometrial tissue in one or more places. In most cases, a small hematoma doesn’t cause any symptoms or cause much concern. A large one, however, can cause abdominal pain in the mother and unusual vaginal bleeding during pregnancy. There is a risk of miscarriage when symptoms are present, but close monitoring, bed rest, and medications can greatly reduce the chances of complications.
The causes of a subchorionic hematoma are not fully understood. Problems occur when the outermost layer of the placenta, called the chorionic membrane, separates slightly from the uterine wall. This separation typically occurs in the first trimester or early second trimester of pregnancy. There is no evidence to suggest that an expectant mother’s genetics, diet, age, or activities have anything to do with the problem.
When hematoma occurs, blood pools in front of the uterine wall and gradually seeps into the underlying endometrial tissue. If there is a large amount of blood, a woman may experience spotting or occasionally heavy bleeding from her vagina. Clotting occurs when more blood is released, which can lead to cramping, bloating, and general abdominal pain. A large number of patients who have such hematomas do not experience any unusual physical symptoms.
A subchorionic hematoma can usually be diagnosed with a simple ultrasound. Radiologists can easily tell where blood is being collected, how much is present, and whether or not the placenta or uterus has been damaged by studying the ultrasound images. Once the diagnosis is made, a doctor can explain the details and risks of the situation to the patient and answer any questions the patient may have. The prognosis is very good for most expectant mothers and their babies, especially if the clots are small and there are no major symptoms.
Most obstetricians recommend that their patients get plenty of rest and avoid stressful activities once subchorionic hematomas are diagnosed. They should attend regular checkups so the healthcare provider can see if the internal bleeding is getting better or worse. In some cases, a doctor may recommend taking low-dose blood thinners to prevent clotting and expel the accumulated blood more quickly. Most hematomas gradually dissolve over several weeks, and mothers are able to go full term without further problems.
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