Subchorionic Hemorrhage – Healthnile.com

Subchorionic hemorrhage often causes bleeding during early pregnancy. Blood collects between the uterine wall and the membranes around the growing baby. This can cause light or heavy bleeding, but sometimes there may be no symptoms at all. The exact cause of a subchorionic hemorrhage is not always known, but it may relate to how the placenta attaches to the uterine lining.

Factors like past miscarriages or older maternal age may raise the chances of developing this condition. Learning why subchorionic hemorrhages happen can help expectant parents know what to expect and when to seek help.

Definition of Symptom

A subchorionic hemorrhage is bleeding that happens between the uterine wall and the membranes surrounding a baby during pregnancy. People may also call this a subchorionic hematoma or subchorionic bleed.

One main symptom is vaginal bleeding, which can range from light spotting to heavier bleeding. Sometimes, people have no visible symptoms, and the condition is only found on an ultrasound. Common symptoms include:

Vaginal bleeding during pregnancy.
Mild cramping or abdominal discomfort.
Sometimes no symptoms at all.

The timing and amount of bleeding can vary depending on the gestational age and the size of the bleed. A table below shows how symptoms may relate to gestational age:

Gestational Age	Symptom Frequency
First Trimester	Most common
Second Trimester	Less common, still occurs
Third Trimester	Rare

Some people may notice dark or bright red blood, but not all bleeding early in pregnancy comes from a subchorionic hemorrhage.

Possible Causes/Subchorionic Hemorrhage Causes

Subchorionic hemorrhage, also called subchorionic hematoma or SCH, happens when blood collects between the uterine lining and the chorion. The chorion is the outer layer around the embryo.

The exact cause of subchorionic bleeding is often unknown. In many cases, doctors cannot find a clear reason why it develops. Possible factors linked to subchorionic hematomas include:

Small blood vessels breaking in the uterus.
Implantation of the embryo causing tiny tears.
Maternal blood clotting disorders.
Trauma or injury to the abdomen.
High blood pressure or early preeclampsia.
Use of certain drugs that affect blood flow.

A table below summarizes some possible causes:

Cause	Details
Blood vessel tear in uterus	Small vessels near the chorion may break.
Implantation	Embryo attaching to uterine wall can cause bleeding.
Blood clotting problems	Issues like thrombophilia may make clots form more easily.
Trauma	Blows or falls can injure the uterine wall.
Severe high blood pressure/preeclampsia	Can make blood vessels more likely to break.
Certain medications or drugs	Substances affecting blood flow might raise the risk.

Most subchorionic hematomas happen in the first trimester. Women with SCH may have vaginal bleeding or spotting, but sometimes there are no symptoms. Subchorionic bleeding is common and usually not linked to anything the mother did. Many times, the bleeding goes away on its own without any lasting problems.

Other Non-Disease Causes

Not all subchorionic hemorrhages come from disease or medical conditions. Sometimes, simple physical processes or events in early pregnancy can lead to this type of bleeding.

Mild trauma to the abdomen, such as bumping into something or a minor fall, can sometimes cause a small bleed between the uterine wall and the chorionic membrane. Lifting heavy objects or sudden, intense physical activity may also play a role for some people.

Procedures in assisted reproduction, like frozen-thawed embryo transfer, can be linked to a higher chance of subchorionic hemorrhage. The process can sometimes disrupt how the embryo attaches to the uterus because the lining may be thinner or not fully ready. A list of other non-disease causes might include:

Physical strain or exercise.
Sexual intercourse, especially early in pregnancy.
Routine ultrasound or other gynecological exams.

These causes are usually less serious than disease-based reasons, but any bleeding should be checked by a healthcare provider.

Important Note: Subchorionic hemorrhage is not the same as ectopic pregnancy, placental abruption, or molar pregnancy, although these conditions can also result in bleeding. Those are considered disease-related and may need urgent medical attention.

How It Causes the Symptom

A subchorionic hemorrhage forms when blood collects between the uterine wall and the gestational membranes near the placenta. This space is usually sealed, so when blood leaks in, it builds up and forms a pocket or clot.

This pooled blood can put pressure on the membranes and the lining of the uterus. The body may release some of this blood through the cervix, which leads to vaginal bleeding. Common symptoms include:

Vaginal bleeding (ranging from light spotting to heavier flow)
Mild abdominal pain or cramping
Passage of small clots in some cases

Bleeding comes from the disruption of blood vessels in the area where the placenta attaches to the uterus. The placenta can still work normally, especially if the hemorrhage is small.

Symptom	How It’s Caused
Vaginal bleeding	Blood escapes from behind the membranes.
Cramping	Uterus reacts to the presence of blood.
Blood clots	Larger blood collections sometimes come out.

Not every subchorionic hemorrhage causes symptoms. If the bleeding is minor or the clot is small, a person may not notice any signs. Some cases are only discovered during an ultrasound exam.

Possible Complications

A subchorionic hemorrhage can sometimes lead to complications during pregnancy. Some women may experience no issues, but others could have concerns depending on the bleed’s size and location. Common complications include:

Vaginal Bleeding: This is the most frequent symptom. While it can be mild, heavy bleeding may occur in some cases.
Pregnancy Loss or Miscarriage: The risk is higher when the hematoma is large or does not go away.
Preterm Delivery: Large or persistent bleeds may increase the chance of delivering the baby early.
Placental Problems: In some situations, the hematoma can cause issues with how the placenta attaches to the uterus.

These complications are more likely if the hematoma takes up a significant space or happens early in the pregnancy. Smaller bleeds, especially those that shrink or disappear, are less likely to cause problems.

Complication	Description
Vaginal Bleeding	May be light or heavy, with or without pain.
Pregnancy Loss	Higher risk with larger or ongoing hematoma.
Preterm Delivery	Early birth risk can increase in some cases.
Placental Issues	Possible problems with placenta attachment.

When to Seek Medical Attention

Vaginal bleeding in pregnancy can be worrying. It may be the first sign of a subchorionic hemorrhage. Seek medical attention right away if any of the following occurs:

Heavy or prolonged vaginal bleeding
Severe abdominal or pelvic pain
Cramps that do not stop
Dizziness or fainting
Fever or chills

If bleeding is light and stops quickly, let your healthcare provider know. Even small amounts of blood should not be ignored during pregnancy. A doctor can check the size of the hematoma and the health of the pregnancy with an ultrasound. Regular checkups help manage risks.

Sometimes, your provider may ask you to reduce physical activity or avoid travel. Each situation is different, so follow your care plan. If new symptoms appear, such as severe pain or passing large blood clots, call your doctor or go to the emergency room right away.

Symptom	Action
Heavy bleeding	Seek emergency medical care
Mild spotting	Inform healthcare provider
Severe pain	Contact doctor immediately
Dizziness/fainting	Get medical help as soon as possible