Ultrasound is an exciting time to check the baby’s growth and see his beautiful features on the screen, but it can sometimes be a stressful experience with surprising revelations. A potential complication that can be detected during ultrasound is a subchorionic hemorrhage.
If you’ve been diagnosed with subchorionic hemorrhage, it’s understandable to have questions about what this means for you and the baby’s health. The good news: Subchorionic hemorrhages usually resolve on their own. Here’s what you need to know about the condition.
What is a Subchorionic Hemorrhage?
A subchorionic hemorrhage is a clot or bleeding that occurs between the wall of the uterus and the chorionic membrane (the early embryonic tissue that will become the placenta), explains Michael Cackovic, MD, a maternal-fetal medicine physician at Ohio State University Wexner Medical Center. This is sometimes referred to as a subchorionic hematoma or subchorionic bleeding, says Cleveland Clinicand it is one of the most common causes of vaginal bleeding in pregnancy between the 10th and 20th week.
“This is an ultrasound finding that we believe is evidence of the pregnancy chorion partially separating from the uterine wall,” he added. Matthew CarrollMD, assistant professor of obstetrics and gynecology at Baylor College of Medicine and Texas Children’s Hospital.
“I try to explain it to people this way: The placenta separates from the uterine wall later in pregnancy. Subchorionic hemorrhage is a similar process but happens really early—before we call the tissue of pregnancy the placenta,” more. Come on Campbell-OparajiMD, associate professor in the department of obstetrics, gynecology and women’s health at Rutgers New Jersey Medical School.
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What Causes Subchorionic Hemorrhage?
Looking for a specific cause for an identified subchorionic hemorrhage? Unfortunately, you won’t get one. “We don’t know what causes it,” Campbell-Oparaji said. That said, there are several risk factors associated with this type of clot. According to Christine GrevesMD, a board-certified ob-gyn at Winnie Palmer Hospital for Women and Babies in Orlando, these include:
- Pregnancy trauma (ie, you were in a car accident or hit in the stomach)
- Vascular dysfunction
- Uterine abnormalities
- Miscarriage history
- Hypertension
- in vitro fertilization (IVF)
However, Carroll added that most cases of subchorionic hemorrhage are spontaneous and random.
Potential Risks of a Subchorionic Hemorrhage
It may sound scary, but it’s reassuring to know that most cases of subchorionic hemorrhage resolve spontaneously, Cackovic reiterated. Of course, it’s also important to know that miscarriage is a possibility. “It’s associated with early pregnancy loss,” Carroll said. “There was also a smaller association between subchorionic hemorrhage in earlier pregnancy and preterm labor, premature rupture of membranes and pregnancy-induced hypertension.”
Note that these risks are also often related to the size of the bleed. If the clot is more than 25 percent of the gestational sac, it may be more closely associated with pregnancy loss, Cackovic says. Fortunately, early diagnosis of a subchorionic bleed does not increase adverse outcomes after 20 weeks. So while this may be related to early loss, research shows that the risk of miscarriage actually decreases after you reach the 20-week mark. On the other hand, if it is spotted after at that point, it may indicate a risk for preterm labor and delivery.
Can subchorionic hemorrhage cause birth defects?
It’s normal to wonder if a subchorionic hemorrhage could negatively affect the baby in any way. Although it is associated with a high risk of miscarriage and preterm birth, Carroll said it is not associated with birth defects.
Symptoms of Subchorionic Hemorrhage
Pregnant people can sometimes experience bleeding from a subchorionic hemorrhage, Greves says. The amount of blood varies though. “It’s rare to have period-like bleeding,” Carroll says. “Most likely, it will be minimal dark bleeding or spotting.”.
However, most cases are asymptomatic—that is, there are no signs, Cackovic says. It can only be diagnosed with a regular ultrasound.
How to distinguish between subchorionic hematoma bleeding versus miscarriage
It is understandable to worry about the risk of miscarriage if you are bleeding during your pregnancy. “We will do an ultrasound and see if it’s a baby [alright] and then provide watchful waiting,” says Campbell-Oparaji. “For the pregnant woman, it’s still nerve-wracking sometimes.”
It’s true that the only way to definitively distinguish between bleeding from a subchorionic hematoma and bleeding from a miscarriage is to do an ultrasound, says Cackovic. “The ultrasound will confirm that there is a good fetal heartbeat,” she said. “Ultimately, the bleeding will be heavier with the miscarriage.”
How Is a Subchorionic Hemorrhage Diagnosed?
Again, a subchorionic hemorrhage was diagnosed on an ultrasound. “We monitor the symptoms—the bleeding and cramping, if there is any,” Carroll said. “We will also repeat the ultrasonography if there are worsening symptoms.”
Treatment of Subchorionic Hemorrhage
Usually, there is no treatment for a subchorionic hematoma. Most cases resolve on their own within a few weeks. “I’ve seen resolutions within a week and as long as a month,” Cackovic says. “The chorion will ‘heal itself’ in those cases.”
Your doctor may suggest you avoid strenuous physical activity, but Cackovic says bed rest isn’t associated with better results. This is more of a wait-it-out situation. A follow-up subchorionic hemorrhage ultrasound may be scheduled to provide reassurance for both patient and provider.
Can certain foods help heal subchorionic hemorrhage?
Being told to wait and see can be difficult, and you may have questions about whether you can do something proactively to help the situation. If a quick Google search tells you that certain foods can help heal a subchorionic hemorrhage, proceed with caution. The truth is that there are no known natural remedies for a subchorionic hemorrhage. Experts say there isn’t enough evidence to suggest that supplements or changes in your diet will help resolve bleeding faster—or at all, for that matter. “People have a lot of questions, but not a lot of answers,” Campbell-Oparaji said.
No one wants to know about any pregnancy complications, but if you’re told you have a subchorionic hemorrhage, try not to stress. Most likely everything will develop normally, and the bleeding will resolve. Meanwhile, tighten up.
Michael Cackovic, MD, is a maternal-fetal medicine physician and clinical associate professor at Ohio State University Wexner Medical Center. He earned his medical degree from Hahnemann University Hospital in Philadelphia.
Matthew Carroll, MD, is an assistant professor of obstetrics and gynecology at Baylor College of Medicine and Texas Children’s Hospital. He earned his medical degree from Mount Sinai School of Medicine in New York City.
Christine Greves, MD, is a board-certified ob-gyn at Winnie Palmer Hospital for Women and Babies in Orlando. He earned his medical degree from the University of South Florida College of Medicine.
Come on Campbell-Oparaji, MD, is an associate professor in the department of obstetrics, gynecology and women’s health at Rutgers New Jersey Medical School. He earned his medical degree from Temple University School of Medicine in Philadelphia.
Please note: The Bump and the materials and information it contains are not intended to, and do not constitute, medical or other health advice or diagnosis and should not be used as such. You should always consult a qualified physician or health professional regarding your specific circumstances.
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