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Subchorionic Hematoma
Frequently Asked Questions Page

First of all, I want to make it very clear, I AM NOT A DOCTOR, AND I DO NOT HAVE ANY MEDICAL TRAINING. I just decided to use the resources around me to research the condition I was diagnosed with. Double check any advice you see here with your doctor before following it. I created this page as a source for information. It is only ONE source. I believe the more sources you find information from, the more credible your information. IF YOU ARE A DOCTOR OR NURSE AND WANT TO COMMENT ON THE INFORMATION BELOW, PLEASE DO NOT HESITATE TO CONTACT ME.

What is a subchorionic hematoma?
A hematoma, or blood clot, is a collection of blood that has caused the placenta to prematurely separate from the uterine wall. Probably due to a ruptured blood vessel, the blood that travels around the sac, collects and creates a pool of blood, or clot. This usually causes anything from light spotting to heavy bleeding that may come and go. Most hematomas (that are big enough) can be detected by an ultrasound. The location of the clot can be important in determining the outcome, since a clot very near the placenta can be more dangerous than a clot further away from the placenta. Size also seems to sometimes affect the outcome. Obviously, a smaller clot is of less concern than a larger clot, which means a larger separation. I have heard of clots ranging from about 1 cm to 12 cm+ in size. (A hematoma is basically a ?mini-abruption? or a placental abruption that occurs earlier in pregnancy. It?s very unlikely that you?ll find ?subchorionic hematoma? in the index of a pregnancy book, but most have a short section on ?placental abruptions.? These will offer you some information, but remember the two are similar, yet different.)

Is this condition harming my baby?
Chances are, the baby is oblivious to the fact that he or she is sharing the womb with a blood clot. Many women report ultrasound after ultrasound where baby grows and develops as it should, despite the hematoma. There should be no adverse or long-term effects. (As a pregnancy progresses into the second trimester, if the clot is QUITE large, it may be wise to ask your doctor if the clot is "cramping" your baby's space.)

Did I do something to cause this?
Apparently, the cause of these are unknown. I have never heard any doctor state there was a reason for a hematoma. I have heard that they may have begun as a ruptured blood vessel, possibly from the time of implantation. Obviously, this is not something a woman could cause or prevent.

Is this going to cause me to have a miscarriage?
There are basically 3 outcomes which can occur with a hematoma.
1) The hematoma resolves itself by healing the separation and reabsorbing back into the body. (Most hematomas that are going to resolve, do so by approximately Week 20.)
2) The hematoma will sometimes create a significant separation from the uterine wall that compromises the baby?s health and results in miscarriage.
3) The hematoma will neither resolve nor cause a miscarriage, and could be present until delivery.
*I have most commonly heard miscarriage rates ranging from 20% to 50%. These rates may be affected by the time of onset, the size of the hematoma, and the location of the hematoma.

What can I do? Should I be on bedrest?
Doctors all prescribe something a little different in regards to a safe activity level, everything from no restrictions at all to strict bedrest. Most often, some form of bedrest is prescribed, but it is not a guarantee, it is a precaution. Everyone agrees, however, that it?s important to ?TAKE IT EASY!?
*No heavy lifting. (Remember this if you have kids. One doctor said nothing heavier than a gallon of milk.)
*Keep your heartrate low. Blood is an irritant to the uterus. As your heartrate goes up, so can the amount of blood passing by (and maybe settling in) the uterus. So keep it slow. If you feel your heartrate increasing, stop all movement and lay down on the left side if possible. Take long slow breaths in and out till you feel yourself calming.
*No straining. You may be surprised at some of the things you do every day that are strenuous. I noticed the pop-up leg rest on our Lazboy was very hard to push down without using my abdominals, so I let my husband do it for me. Sometimes prenatals make women constipated. Keep this in mind and increase your fiber if necessary.
*Full pelvic rest is almost always prescribed. This means no intercourse or tampons. My doctor refused to do any vaginal exams also. (He only performed abdominal ultrasound after 12 weeks, no vaginal ultrasound or exams).

Can the hematoma be removed or operated on?
No, there is no such surgery that can be performed to remove a hematoma. Bedrest is the most commonly prescribed treatment, and works for many women.

Should I see a specialist?
If improvement is not seen by 16 weeks, it's probably time for your general obstetrician to refer you to a perinatologist, which is ?an obstetrician who has extra training in caring for mothers with complicated pregnancies or anticipated problems at birth. He or she practices at a major medical birth center and usually sees patients referred by primary health-care providers. Oftentimes, the perinatologist will comanage a mother?s labor and delivery along with her regular obstetrician.? (from ?The Pregnancy Book,? by Sears and Sears.) It may comfort you to know that some ?peri?s? see several hematoma cases every week! Of course, any time you are uncomfortable with your present care, you should seek out a doctor who makes you feel more at ease.

I've had a hematoma for months now. Can I finally breathe easy that no harm is going to come of it?
As you make it into and past the 2nd trimester, you may need to be monitored carefully to avoid pre-term labor.

Is there anything else I can do?
Drink lots of water! It?s a good idea to consume at least a half a gallon a day (8 8-oz. glasses). You?ve probably heard that people are often dehydrated and don?t realize it. (This is a common cause of headaches.) Not getting enough water may cause mild contractions in the uterus, which can be dangerous. So keep yourself well-hydrated!

The odds are in your favor for a good outcome if you take it easy! There are lots of success stories out there! : )

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Subchorionic Hematoma / Subchorionic Hemorrhage in Pregnancy