Vaginal bleeding is too frightening for a woman who is pregnant. Abnormal accumulation of blood (a blood clot) in space between the uterine wall and chorionic membrane is called subchorionic hemorrhage. This condition is also known as subchorionic hematoma. The exact cause is it not known and it is detected with the help of sonography. Subchorionic membrane is rare, only 1 percent of pregnancy is known to develop it.
In most cases subchorionic hemorrhage is not serious and the blood clot gets reabsorbed. However, if bleeding is in large amount it may separate the placenta from the uterine wall leading to complications like preterm birth or threatened abortion.There is no specific treatment for subchorionic hemorrhage. Rest and reassurance to the patient is generally advised by the doctor.
What Causes Subchorionic Hemorrhage?
Medical fraternity is still not able to detect the exact cause of subchorionic hemorrhage. The fetus lies inside the uterus and is covered by thin membranous fluid filled bag called amniotic sac. This bag has two sides; the inner contains fluid called amnion fluid which protects the fetus from jerks and trauma. The outer membrane is called chorion. Placenta is formed of chorion and endometrium of uterus. It is life line for supply of nutrients and oxygen for the fetus.
Subchorionic hematoma is believed to form when the egg slightly detaches during the stage of implantation on the uterine endometrium. It then leads to bleeding. Usually subchorionic hemorrhage occurs during the first trimester of pregnancy. It is seen more in women who conceive after the age of 35.
Symptoms Of Subchorionic Hemorrhage
In majority of cases bleeding through vagina is the first symptom of subchorionic hemorrhage. Bleeding can be mild spots or severe depending on the severity. It may be associated with slight discomfort in pelvic region. However, all pregnant women who have this condition may not complain of bleeding, sometimes the amount is very small and the clot might be only detected during the routine sonogram examination.
If the hematoma is too large it can lead to spontaneous abortion or partial rupture of placenta. These two complications adversely affect the course of pregnancy therefore even though patient has slight bleeding from vagina, she should immediately consider fixing an appointment with her doctor.
Treatment For Subchorionic Hemorrhage
In majority of cases, if subchorionic clot is detected during pregnancy, doctors advice the patient to take complete bed rest for at least till the end of first trimester. Rest reduces increased heart rate and blood flow. Ideally, in more than half of patients, the clot gets reabsorbed. If the clot is large in size, regular monitoring is needed with the help of ultrasound. Large sized subchorionic hematoma increases the risk of placental rupture or threatened miscarriage.
The patient should strictly refrain from lifting heavy objects, stay away from doing strenuous work as it may initiate bleeding. It is also essential to prevent constipation during this period. Patient should drink enough water and eat more fiber containing foods to prevent constipation. Patient suffering from constipation has to strain during bowel movement and it can increase pressure on the uterine lining and chorionic membrane.
In some cases the doctor may also recommend estrogen and progesterone therapy for preventing miscarriage.