Learning About Subchorionic Hematoma

A subchorionic hematoma or hemorrhage is bleeding between the wall of the uterus and one of the sacs (chorion) that surround the fetus inside the uterus during pregnancy. It can also happen between the uterine lining and the placenta. It’s a common cause of vaginal bleeding in early pregnancy.

In most cases, the bleeding goes away on its own and the baby is born healthy. But in some cases, the bleeding may cause the placenta to separate from the wall of the uterus. The bleeding may be a sign of a miscarriage or other problem with the pregnancy.

The cause of a subchorionic hematoma is not known. But it may happen if you have:

• Trauma while pregnant.
• Problems in the placenta or uterus.
• Blood clotting problems.
• A miscarriage.
• A pelvic infection.

The main symptom is bleeding from the vagina. Some people may also have pain or cramping in the belly. Sometimes people have no symptoms. The condition might be found during an ultrasound test that was done for other reasons.

If you are having symptoms, such as vaginal bleeding, your doctor or midwife will ask about your health history, including:

• Your past pregnancies.
• Any problems you've had with your pregnancies.
• Whether you've had any sexually transmitted infections (STIs) or pelvic inflammatory disease.

You will also be asked whether any bleeding from your vagina is:

• Light or heavy.
• Constant or off and on.

Your doctor or midwife will likely ask if you have belly pain or cramping.

Your doctor or midwife will check your belly and do a vaginal exam to see how much bleeding you have. Your cervix may also be examined.

An ultrasound will usually be done. It can show if there is blood trapped between the chorion and the wall of the uterus.

In cases where you don’t have symptoms, a subchorionic hematoma may be diagnosed during a routine pregnancy ultrasound.

In most cases, no treatment is needed. The bleeding goes away on its own. Your doctor or midwife may do a follow-up ultrasound and advise you not to do any strenuous activity or heavy lifting.

If the bleeding causes other problems, your doctor or midwife can treat or manage them. For example, you may get treatment if the hematoma makes the placenta separate from the wall of the uterus or causes preterm labor.