Subchorionic Hemorrhage

A Cause of Bleeding in Pregnancy

Pregnancy Ultra-Sound
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"I had an ultrasound when I was bleeding and diagnosed with a threatened miscarriage, they said I had a subchorionic hemorrhage."

Any time that you have bleeding in pregnancy, you are rightfully concerned. There are many reasons that you could be bleeding in pregnancy. One of those reasons is because of a subchorionic hemorrhage. 

What is a subchorionic hemorrhage?

A subchorionic hemorrhage is not quite as drastic as it sounds.

We tend to hear the word hemorrhage and image pools of blood and no good outcomes. A subchorionic hemorrhage is bleeding between the amniotic sac (membranes) and the pregnancy, usually found near the placenta. This is something that may or may not be associated with an increased risk of miscarriage, depending on the size, location, symptoms and when it is found in the pregnancy.

You are more likely to have a subchorionic hemorrhage if you are pregnant after in vitro fertilization (IVF) or a thawed embryo transfer. You may also have a higher incidence if you are pregnant with a baby that is not your first baby. And the your age also is a factor.

How often do you see a subchorionic hemorrhage?

Subchorionic hemorrhage happens in about 1% of all pregnancies, but it is the cause of about 20% of all the bleeding in the first trimester. About a quarter of women will experience bleeding in the first trimester.

A subchorionic hemorrhage may cause bleeding that is visible or you may only see it during an ultrasound done in pregnancy for a different reason. It can be varying in quantity from spotting in pregnancy to heavy bleeding. The blood can be pink in color to bright red or brown. Ultrasound is used to diagnose the bleeding.

Pregnancy Outcomes with a Subchorionic Hemorrhage

Certainly having any area of bleeding in pregnancy can increase the risks of complications to the pregnancy. Some women who have a subchorionic hemorrhage will have a miscarriage or go into preterm labor, more so than women who do not have a subchorionic hemorrhage. There is a correlation with the size of the hemorrhage, the larger the area of bleeding, the more likely you are to have a complication. Though this is certainly not true for all cases. 

You may also hear people talk about this as a subchorionic hematoma. This is the same thing, but another name for it.

Your doctor or midwife can help you understand what your specific risk factors are in terms of having a subchorionic hemorrhage as well as the likelihood it will cause you problems in your current pregnancy. Routine prenatal care, certain prenatal tests, and good follow up will be helpful.

Sources:

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Chhabra, A .Subchorionic Hemorrhage. eMedicine. Last accessed February 22, 2016

Janowicz-Grelewska A, Sieroszewski P. Ginekol Pol. 2013 Nov;84(11):944-9. [Prognostic significance of subchorionic hematoma for the course of pregnancy].

Mazzariol FS, Roberts J, Oh SK, Ricci Z, Koenigsberg M, Stein MW. Clin Imaging. 2015 Mar-Apr;39(2):176-85. doi: 10.1016/j.clinimag.2014.10.009. Epub 2014 Oct 23. Pearls and pitfalls in first-trimester obstetric sonography.

Palatnik A, Grobman WA. Am J Obstet Gynecol. 2015 Sep;213(3):403.e1-4. doi: 10.1016/j.ajog.2015.05.019. Epub 2015 May 14. The relationship between first-trimester subchorionic hematoma, cervical length, and preterm birth.

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