A subchorionic hemorrhage, also known as a subchorionic hematoma or simply SCH, is created when blood gathers in the space between the placenta and uterus. The technical term is chorion, but many doctors will simply call it a blood clot. These clots can be serious because they might grow large, and thus cause the placenta to separate from the uterine wall. This is especially true if the clot or bleeding becomes too large, cannot be reabsorbed by the body, or develops in a spot that makes separation more likely.
What Is Subchorionic Hemorrhage?
Understanding what it is can help parents-to-be understand what the risks really are. Here is a rundown of the causes, symptoms and possible complications.
In most cases, no one really knows why a subchorionic hemorrhage develops. In some cases, the egg might pull away from the uterine wall in early pregnancy, leading to blood clot formation. Scientists believe that those who are over the age of 35 are more possible to have this condition. However, chances of different races being affected by the condition are equal. Unfortunately, without a clear cause or risk factors, there is no way to truly prevent a SCH, and there is no known treatment for the problem.
In most cases, the first symptom of a subchorionic hemorrhage is vaginal bleeding. This can be very heavy or very light. Because bleeding might also be a sign of miscarriage, calling your doctor the moment you notice it is a good idea. On the other hand, there might never be symptoms if the hemorrhage is quite small, and it might be found during a routine ultrasound. Many of these blood clots simply form, stay for a while, and resolve on their own without causing any harm to mother or baby.
Possible Complications and Risks
If the subchorionic hemorrhage is small, it will never affect the pregnancy, except the occasional bleeding that might frighten the mother. A larger blood clot might lead to complications, such as preterm labor or restricted growth of the fetus. The risk of miscarriage tends to go up when a woman is diagnosed with this type of blood clot, especially if the diagnosis happens early in the first trimester, or if the blood clot is very large.
How Is It Diagnosed?
Fortunately, diagnosis of the problem is easy and painless: It is usually found during an ultrasound examination. Sometimes it is found because a woman has started bleeding and is concerned, but even those that do not bleed can usually be easily spotted on the ultrasound. The ultrasound can tell many details about the SCH, such as how big it is, how much bleeding there is, where the blood is collecting, and whether the placenta has been damaged by the growing blood clot.
Follow-up ultrasounds can confirm that things are getting better or worse. A doctor or radiologist can then explain the problem, the prognosis, and the risks. Fortunately, those who haven’t experienced heavy bleeding or those who have very small clots are probably not going to deal with any further symptoms or problems. For most expecting mothers, the subchorionic bleed simply turns out to be a scary moment or two, and it doesn’t affect their pregnancy or their baby in the long term.
How to Cope With Subchorionic Hemorrhage
In most cases, a doctor will want to take a wait-and-see approach to the SCH. This means that mom needs to take care not to make things worse during that time. Mothers should increase their intake of fiber and water to prevent constipation, so there is no straining at the toilet. They should rest to avoid an increased heart rate. Avoid strenuous physical activities, such as serious exercise, and don’t lift heavy objects.
In most cases, the clot resolves itself within the first trimester or early in the second trimester. But sometimes it continues to be an issue, and must be carefully monitored with regular ultrasounds. Some doctors will deal with a serious subchorionic bleed by giving the mother blood thinners. However, this is only after weighing the pros and cons against possible miscarriage. If at any time you feel pain, cramping, or the bleeding becomes worse, it’s time to head to the doctor immediately.
Should You Worry?
Any mother who sees bleeding during her pregnancy needs to be concerned. After all, you have no idea what causes it, and your first instinct is that it must be something bad. So when you do see blood, notify your doctor immediately, and get into the office as soon as possible for an ultrasound. You will likely be one of the lucky women who get your mind put at ease when you see a great-looking ultrasound and realize the bleeding was just a fluke.
But what if it is a subchorionic hematoma? In that case, the news is still pretty good. Most of these wind up resolving on their own, and you can continue to have a healthy, happy pregnancy. But those that do not dissolve do increase the risk for miscarriage, and that is why it is vitally important to keep all prenatal appointments, show up for all ultrasound screenings, and monitor your body closely for changes in bleeding, any pain, and other health problems that might pop up while you are dealing with this issue.
Besides, over half of women who suffer bleeding in early pregnancy go on to have healthy babies. But keep in mind that these women were constantly monitored for problems, and you should do the same. If you have a large blood which lasts into the third trimester, the chances of a placental abruption or preterm labor increase. When you are in the third trimester, any unusual bleeding, pain, cramping, or other symptoms should be concerned and you should go to the hospital immediately. It is always better to be safe rather than sorry!