Subchorionic hematoma: What next?

November 29, 2007 11:40 AM

Ever had a subchorionic hematoma? First trimester, just diagnosed. What should I expect? (Somewhat graphic description included inside).

I'm about 10 weeks pregnant. 39 years old. First pregnancy. Had some bleeding (bright red, a few small clots) yesterday after lunch and immediately called my OB office, figuring on the worst. They set me up with an ultrasound that afternoon and found a small (~1 cm) subchorionic hematoma. Otherwise, I guess things look fine. (As a bonus I got to see the heartbeat for the first time! Freaky!). Everyone I talked to yesterday and today both at the ultrasound and with an advice nurse today basically says: wait and see. I guess bleeding is not entirely unheard of while pregnant and there's nothing to do except hope it doesn't get worse. But what is worse? Can this progress into something dangerous to me or the fetus? They say that usually these things "resolve" themselves but also said to watch for heavy bleeding. I haven't bled since that one time yesterday but I'm still a little weirded out by the whole thing. They also say, but overexert yourself and don't have sex for a few days but I'm not exactly sure why. Isn't it just a blood clot? I know you are not my doctor. I have seen a doctor and talked with a nurse and will have another ultrasound next week. In the mean time, anecdotal experiences and thoughts are appreciated.

posted by otherwordlyglow to health & fitness (8 comments total)

During my first pregnancy, I had several occassions of light bleeding and had a very very healthy child. I don't know what caused mine, so i cannot advise on experience with your hematoma. I think you will know heavy bleeding should it happen, but if it were me I would call them if any additional bleeding at all or any cramping with or without bleeding occurs. Sometimes doctors and nurses are so used to seeing things in a pregnancy they forget how nerve shattering it can be to have happen to you. Take their advice and take it easy. It can't hurt. Good luck to you.
posted by domino at 11:55 AM on November 29, 2007

I had some bleeding when I was pregnant and everything turned out fine. I don't think the doctor even gave me a diagnosis - he just said that light bleeding sometimes happens and I should call if it got worse. It happened a few times during the first trimester and then stopped.
posted by bedhead at 11:57 AM on November 29, 2007

I had a pretty massive subchorionic bleed with my second pregnancy at about 10w along. I can remember it clear as day. Was standing in Baby Gap with a girlfriend. My older kiddo spilled juice all over herself and was in dire need of dry clothes. Suddenly, I looked over to my friend and told her either I peed or was bleeding big time. Never knew Baby Gap had bathrooms before that...

Anyway... I was *convinced* I had miscarried. I have no idea how I made it back to the RE's office in one piece so fast. There was still a heartbeat and everthing was fine. My utter bitch of an RE (a whole other story) gave me an awful earful of how high risk I was and scared the bejesus out of me. I also got a booster shot of a half dose of hCG "just in case".

I then called my OB (who is a high risk practitioner at a major NYC teaching hospital), followed up with another call to my BIL who is the head of RE at different major NYC teaching hospital. I then went in to my OB's office for him to do his own ultrasound and talked to his female partner and told her what happened. She assured me it would be OK. You know what? Between all three of these OBs , ALL overwhelmingly told me that in their collective years of practicing they had less than FIVE pregnancies gone bad because of subchorionic bleeds.

The overwhelming advice from all four doctors (including the bitch RE) was to drink plenty of fluids, lay low until the bleeding stops, no heavy lifting/exertion, and no getting frisky (as if).

IRC, I bled off and on for the rest of the first trimester and maybe a couple weeks into the second. It's kind of a good reminder to ease up on any stupid behaviour (uh, like moving bookcases). Just know that because of the bleed, if you choose to do a triple screen, you are much more likely to get a false positive.

So Girlie, put your feet up, chug some Gatorade and update your Netflix queue for few days. I'm sure you'll be OK. Mefimail me if you want to chat.
posted by dancinglamb at 12:35 PM on November 29, 2007 [2 favorites has favorites]

Oh, and to clarify, a sub-chorionic bleed is when the placenta pulls away from the side of the uterus. You can see where the clot forms on an ultrasound (which is what they measured when they did yours yesterday).

When they say 'gets worse', they mean bright red heavy bleeding (think 2nd day of AF bleeding). Don't worry about dark red/thick stuff. That's old blood that your body is getting rid of.

But, seriously, you'll likely be fine. I found that if I was acting like an idiot doing stuff I shouldn't have been doing (the aforementioned bookshelves), then I'd run into problems. But normal, everyday life - no worries. Well, unless you're like a gladiator or something.
posted by dancinglamb at 12:44 PM on November 29, 2007

No one ever tells you how terrifying pregnancy can be. Bleeding is one of those times. I started bleeding at 14 weeks (ironically, the day after we "went public" with the pregnancy). I was diagnosed with a hematoma and a low-lying placenta. That combination led to a lot of blood. When I asked about the risk to the baby, the doctor explained that if I went back to my normal life, the baby would be in a great deal of danger but if I took it easy until everything healed, the risk was low. I ended up on bedrest for eight weeks. I doubt that will happen to you, especially since you haven't bled much, but my point is take it easy and let your body heal itself.

Even if the active bleeding has stopped, you may still have blood inside you that'll have to come out. The only blood that should concern you is heavy, red blood--described to me as enough to fill a pad in a short time. But knowing that the brownish blood is normal doesn't make it less unnerving. If you get concerned at any point for whatever reason, go ahead and call your doctor. The stress of being worried isn't good for the baby either, and anyway, doctors are used to neurotic pregnant women.

Oh, after my eight weeks of boredom, I got the free and clear. Everything healed up and I'm not considered at all high-risk. (28 weeks and counting!)
posted by wallaby at 1:11 PM on November 29, 2007

My story with my first pregnancy was just like dancinglamb. Spotting for a while and then a major bleed that scared me to death!! Most terrifying time in my life till I could get to the Dr the next morning. Everything was fine and she's practicing her piano right now. Bled a little with my second pregnancy but no major flow like the first one. Stay off your feet and follow Dr's orders. Including pelvic rest. Best of luck to you and congrats!!
posted by pearlybob at 2:34 PM on November 29, 2007

Thanks for the reassurances. As I said before, pregnancy is just plain weird. I do plan on taking it easy and haven't noticed any bleeding since the one time. Though that one time did seem like slightly more than "spotting" and since it was bright red (it really did look like a period), I was (am?) a little freaked out.
posted by otherwordlyglow at 3:06 PM on November 29, 2007

My wife had exactly the same thing for one of our two boys--it was _really_ stressful when it happened. I remember bracing ourselves for the worst, and having a couple of bad weeks of crossing our fingers after we saw what was happening on the ultrasound.

In the end, though, it was totally fine. (Unless that's what gave him the power to transform a total _brat_. If that's why he's that way, then you're screwed.)
posted by LairBob at 6:45 PM on November 29, 2007