Subchorionic Bleeding

Overview of Subchorionic Bleeding

Subchorionic bleeding is a condition that occurs during early pregnancy when blood accumulates between the uterine lining and the gestational sac or placenta. It can lead to the formation of a blood clot or hematoma, which can cause vaginal bleeding or spotting. This condition is also known as subchorionic hematoma or subchorionic hemorrhage.

Prevalence of Subchorionic Bleeding

Subchorionic bleeding can occur in up to 20% of all pregnancies and is more common in women who have experienced vaginal bleeding or have had previous miscarriages. It is the most common cause of vaginal bleeding in women about 20 weeks gestational age with an incidence of about 11% of cases.

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Signs and Symptoms of Subchorionic Bleeding

The most common symptom of subchorionic bleeding is vaginal bleeding or spotting during pregnancy. The bleeding may range from light spotting to heavy bleeding and may be accompanied by abdominal pain or cramping. Other symptoms may include:

  • Vaginal discharge: Some women with subchorionic bleeding may experience a watery or mucus-like vaginal discharge.
  • Back pain: In some cases, subchorionic bleeding may cause lower back pain.
  • Decreased fetal movement: If subchorionic bleeding is severe or leads to complications, it may cause decreased fetal movement or other signs of fetal distress.
  • Anemia: If subchorionic bleeding causes significant blood loss, it may lead to anemia, which can cause fatigue, weakness, and shortness of breath.

It is important to note that some women with subchorionic bleeding may not experience any symptoms, and the condition may be detected only during routine ultrasound examinations.

If you experience vaginal bleeding or abdominal pain during pregnancy, it is essential to seek medical attention. Your gynecologist can evaluate your symptoms and perform diagnostic tests, such as an ultrasound or blood test, to determine the cause of your symptoms and develop a treatment plan if necessary.

Types of Subchorionic Bleeding

Subchorionic bleeding has different types based on the location and severity of the bleeding. Here are some of the subchorionic bleeding types:

  • Small Subchorionic Hematoma: This type of subchorionic bleeding is small and does not pose a significant risk to the pregnancy. It may cause mild vaginal bleeding or spotting but often resolves without intervention.
  • Large Subchorionic Hematoma: A large subchorionic hematoma is a massive accumulation of blood between the gestational sac or placenta and the uterine lining. This type of subchorionic bleeding can be more concerning and may increase the risk of miscarriage, preterm labor, or other complications.
  • Retroplacental Hematoma: A retroplacental hematoma is subchorionic bleeding that happens between the placenta and the uterine wall. It can cause severe vaginal bleeding and abdominal pain and require immediate medical attention.
  • Marginal Hematoma: A marginal hematoma is a type of subchorionic bleeding that occurs at the placental edge. It may cause mild vaginal bleeding or spotting, but it is not usually a cause for concern.

The severity of subchorionic bleeding can vary, and treatment will depend on the type and extent of bleeding, as well as the stage of pregnancy.

Causes of Subchorionic Bleeding

The exact cause of subchorionic bleeding is not always known, but several factors may contribute to its development. Some possible causes of subchorionic bleeding include:

  • Implantation: During the early stages of pregnancy, the embryo attaches to the uterine wall and begins to develop. This process can sometimes cause small blood vessels to rupture, leading to subchorionic bleeding.
  • Hormonal changes: Fluctuations in hormones during pregnancy can cause changes in the blood vessels in the uterus, which may increase the risk of subchorionic bleeding.
  • Placenta abnormalities: Abnormalities in the placenta, such as a low-lying placenta or a placenta that detaches from the uterine wall, may increase the risk of subchorionic bleeding.
  • Infection: In rare cases, subchorionic bleeding may be caused by an infection in the uterus.
  • Trauma: Physical trauma to the abdomen, such as a fall or car accident, may cause subchorionic bleeding.
  • Blood clotting disorders: Women with blood clotting disorders, such as thrombophilia, may be at an increased risk of subchorionic bleeding.

It is important to note that in many cases, the cause of subchorionic bleeding is not identified. However, it is important to seek medical attention if you experience any vaginal bleeding or abdominal pain during pregnancy, as these symptoms may lead to a severe condition.

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Risk Factors of Subchorionic Bleeding

Risk factors for subchorionic bleeding include:

  • Advanced maternal age: Women over 35 are at an increased risk for subchorionic bleeding.
  • Previous history of subchorionic bleeding: Women who have experienced subchorionic bleeding in a previous pregnancy are at an increased risk of experiencing it again.
  • Multiple gestations: Women pregnant with twins or multiples are at an increased risk for subchorionic bleeding.
  • Assisted reproductive technologies: Women who have undergone assisted reproductive technologies, such as in vitro fertilization (IVF), are at an increased risk for subchorionic bleeding.
  • Smoking: Smoking during pregnancy increases the risk of subchorionic bleeding.
  • Maternal trauma: Maternal trauma, such as a fall or car accident, can increase the risk of subchorionic bleeding.
  • Placenta previa: Placenta previa, a condition where the placenta covers the cervix, can increase the risk of subchorionic bleeding.

Complications

Some of the complications associated with subchorionic bleeding may include:

  • Miscarriage: The risk of miscarriage is higher in women with subchorionic bleeding, particularly in the first trimester.
  • Preterm labor: In some cases, subchorionic bleeding can lead to premature labor which can cause problems for both the mother and the baby.
  • Placental abruption: Subchorionic bleeding can cause the placenta to detach from the uterine wall, leading to a severe condition known as placental abruption. It can be life-threatening for both the mother and the baby.
  • Infection: Subchorionic bleeding can increase the risk of infection, particularly if the bleeding is severe or occurs later in pregnancy.
  • Growth restriction: In some cases, subchorionic bleeding can affect the growth of the fetus, leading to growth restriction or other developmental issues.

It's important to note that not all cases of subchorionic bleeding lead to complications, and many women go on to have healthy pregnancies and babies.

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Prevention

Subchorionic bleeding cannot always be prevented. However, some steps may help to reduce the risk of developing this condition or its complications:

  • Prenatal care: Regular prenatal care is essential for a healthy pregnancy. It includes regular visits with your healthcare provider, who can monitor your pregnancy and identify any potential issues early on.
  • Avoiding risky behaviors: Avoiding smoking, alcohol, and drugs during pregnancy can help to reduce the risk of complications, including subchorionic bleeding.
  • Rest and avoiding strenuous activities: Resting and avoiding strenuous activities may help to reduce the risk of subchorionic bleeding, particularly in women who have experienced bleeding in previous pregnancies.
  • Managing chronic health conditions: Women with chronic health conditions such as high blood pressure or diabetes should work closely with their healthcare provider to manage their condition during pregnancy, which may help to reduce the risk of subchorionic bleeding.
  • Taking supplements: Taking prenatal vitamins and supplements, such as folic acid, may help to support a healthy pregnancy and reduce the risk of complications.

It's important to note that subchorionic bleeding can still occur despite taking these precautions, and it's important to seek medical attention if any bleeding or unusual symptoms occur during pregnancy.

 

 

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Diagnosis

Subchorionic bleeding is typically diagnosed through physical examination and diagnostic tests. Here are some of the subchorionic bleeding diagnosis methods:

  • Ultrasound: An ultrasound is a common diagnostic test used to diagnose subchorionic bleeding. During an ultrasound, a gynecologist uses a device that emits sound waves to create images of the uterus. If subchorionic bleeding is present, it may appear as a dark area within the placenta or gestational sac.
  • Physical examination: Your healthcare provider may perform a physical examination, which may include a pelvic exam or a speculum exam. They may also ask about any symptoms you're experiencing, such as vaginal bleeding or abdominal pain.
  • Blood tests: In some cases, a healthcare provider may order blood tests to check hormone levels or other markers that may indicate a problem with the pregnancy.

If subchorionic bleeding is diagnosed, your healthcare provider may recommend further monitoring or treatment, depending on the severity of the bleeding and other factors. It's important to follow your healthcare provider's instructions closely and attend all scheduled appointments to ensure the best possible outcome for you and your baby.

Treatment of Subchorionic Bleeding | When to Consult a Doctor

Subchorionic bleeding treatment will depend on the severity of the bleeding, the stage of pregnancy, and the overall health of the mother and baby. Here are some common treatments for subchorionic bleeding:

  • Rest: In cases of mild subchorionic bleeding, your gynecologist may recommend bed rest or reduced activity levels. It may reduce the risk of further bleeding and promote healing.
  • Monitoring: In some cases, your gynecologist may recommend regular monitoring of the pregnancy, such as ultrasounds or blood tests, to check the baby’s health and monitor the bleeding.
  • Medications: In some cases, your gynecologist may recommend medications to help prevent miscarriage or premature labor. These may include progesterone supplements or medications to help control bleeding.
  • Hospitalization: In severe cases of subchorionic bleeding, hospitalization may be necessary. It may include bed rest or other treatments to help manage the bleeding and ensure the health of the mother and baby.

It's important to note that in many cases, subchorionic bleeding will resolve on its own and will not require any treatment. However, it's important to follow your healthcare provider's recommendations closely and attend all scheduled appointments to ensure the best possible outcome for you and your baby. You can consult one of the best gynecologists near you via Healthwire.