Bleeding In Uterus During Pregnancy – Can Subchorionic Hematoma Cause Miscarriage?

Bleeding In Uterus During Pregnancy – Can Subchorionic Hematoma Cause Miscarriage?

Any type of bleeding during pregnancy naturally becomes a cause of concern. It also does not always mean a sign of miscarriage but bleeding is definitely alarming to the senses. After all, theoretically there shouldn’t be any vaginal bleeding during pregnancy phase.

Still, there may be reasons why this could happen and one of them is the formation of blood clot during pregnancy or subchorionic hematoma. We will discuss this in the below story in detail.

Subchorionic hematoma

During pregnancy, certain types of bleeding can be a big issue and subchorionic bleeding or subchorionic hemorrhage is one of them. The condition is believed to occur when the placenta detaches from the wall of the uterus fully or partially. This causes blood accumulation between the placenta and the uterine wall.

The condition typically affects the chorionic membranes leading to formation of sac between the uterus and the placenta. These hematomas can vary in sizes with the larger ones putting the pregnant women at the risk of heavier bleeding.

There are other types of hematomas including retroplacental hematomas which occur behind the placenta and amniotic hematomas which are associated with blood vessels rupture near the umbilical cord.

How common is subchorionic hematoma during pregnancy?

Vaginal bleeding occurs in about half of all the pregnancies and most of them are not harmful. But specifically talking about blood clot, this can affect 1 in every 1000 pregnant women. But some other studies show that this complication can affect as much as 3 percent of all the pregnancies.

What causes this condition during pregnancy?

The reason behind this condition is not completely understood. The first theory is that when placenta, the organ that carries oxygen and nutrients to the child detaches from the uterine wall and causing blood accumulation. Another probability is when the fertilized egg implants in the uterine wall around 4th week, the implant or attachment is somehow abnormal.

Are there any risk factors?

There are some suspected risk factors for this condition. According to multiple studies, subchorionic hematoma has more chances of occurring in pregnancies conceived via in-vitro fertilization (IVF) or frozen embryo transfer.

This condition may also occur in older women and those who already had a baby in the past.

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Signs and symptoms of subchorionic hematoma

The most obvious sign of this condition is the vaginal bleeding which can range from light spotting to heavy flow or even no bleeding at all. Vaginal bleeding is also one of the most common reasons why a woman would go for first-trimester sonography.

Some women may experience cramping and dizziness especially in case of heavier bleeding.

Complications – Do I need to worry about bleeding during pregnancy?

While any type of bleeding that is the direct result of subchorionic hematoma raises concern, rarely it causes miscarriage. If the hematoma or blood clot is small and that develops in the initial phase of pregnancy as well as symptom free, there are good chances of carrying the baby to full term.

Secondly, hematomas found under the placenta or behind the fetal membrane are more concerning than those which are found on the surface. Moreover, hematomas that do not grow are less troublesome as compared to one that forces the placenta to dislodge from the uterine wall.

However, in case of heavy bleeding or how far the hematoma has come along the pregnancy, it can be a sign of:

The doctor is the best person who can determine the exact status of your pregnancy. The risk of miscarriage is greater in the first half of the pregnancy, so it’s better to call the doctor without delay.

Diagnosis of subchorionic hematoma

If you have spotted vaginal bleeding, you would be calling the doctor without delay. The location and the size of clot can affect the degree of risk it poses to the pregnancy. The gynecologist will probably suggest an ultrasound after physically examining the symptoms.

If the condition is not severe, the doctor then may advise come precautions after this, otherwise it may opt for bigger measures such as preterm delivery or c-section delivery.

Does subchorionic hematoma need treatment?

Early diagnosis is the key to counter this condition, however, in few cases. Mostly, the mild cases resolve on its own without any kind of treatment. However, if the diagnosis is subchorionic then the doctor would be putting all his efforts in preventing the chances of miscarriage.

In fact, in most of the cases, the doctor can’t do anything except to wait and watch. Depending on the case, the medicinal options might include progesterone or dydrogesterone to maintain pregnancy as long as possible.

Other precautions may include:

  1. Bed rest
  2. Avoid sex
  3. Avoid long standing
  4. Avoid exercising

Takeaway

Though vaginal bleeding is common, excessive vaginal bleeding is an abnormal phenomena. If that is the case, then it should be immediately reported to the doctor. It is also important to remember than vaginal bleeding can be due to hormonal changes or sex during pregnancy.

Hematoma doesn’t necessarily mean that the pregnancy will eventually fail. Even if it is, many women have delivered healthy babies with healthy practice, proper treatment and close monitoring. So whether or not this condition poses an immediate threat, the best way is to talk to your gynecologist and report any unusual happening. Most probably, all it would need is an ultrasound to rule out the cause of problem.

Sources

1. The Relationship Between First-trimester Subchorionic Hematoma, Cervical Length, and Preterm Birth. read more
2. Perinatal Outcomes in Women With Subchorionic Hematoma. read more
3. Subchorionic Hematoma an In-Vitro Fertilization Pregnancy. 
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