Subchorionic Hemorrhages

Hi Dr Ryen. I'm really worried about my baby. We had an early miscarriage last fall and now we're pregnant again, about 12 weeks along. But an ultrasound showed a bleed. "Subchorionic hemorrhage" the report said, 32 mm x 14 mm x 18 mm. The internet says if they're bigger than 3 cm, there's more chance of losing the pregnancy. Help! I don't want to lose another one. Is there anything I can do to make it heal?

 – Michaela, New Haven, CT

Michaela, I’m so sorry to hear about your last pregnancy. Losses are so awful. Now that you’re expecting again, I’m sure you’ll do anything to avoid the heartache of last time. 

Bleeds between the placenta and the wall of the uterus are common. “Subchorionic” means they’re beneath the chorion (placenta). As the uterus grows, the placenta and uterus call shear slightly. Since both surfaces are full of blood vessels, any separation quickly fills with blood. This is a “hematoma”. Most of the time they gradually reabsorb and disappear. Sometimes small amounts of blood can leak out of you. Rarely, severe bleeding can signal an expanding gap between the placenta and uterus, separating them from each other. This is placental abruption and it’s an obstetric emergency. So if you start bleeding lots, get to the hospital right away. 

At your early stage of pregnancy, there’s nothing to be done about a subchorionic hemorrhage. It’s probably best to avoid intense activity (like kickboxing or full-contact hockey), but there’s no evidence that activity restriction, medications, or avoiding intercourse will change the outcome. It’s just a matter of waiting. Your maternity doctor may order follow-up ultrasounds to monitor things. In the meantime, try your best to avoid googling symptoms – it’ll just increase your anxiety. 

Good luck, Michaela. I hope it all resolves uneventfully and you deliver a healthy baby months from now.

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