Can subchorionic bleeding during pregnancy harm the baby?

Any one with subchorionic bleeding during pregnancy? I need advice. Is it dangerous in pregnancy?" a mum asked us on theAsianparent app.

Subchorionic bleeding (also known as a subchorionic hematoma) is the abnormal accumulation/clotting of blood within the folds of the chorion or between the placenta and the wall of the uterus. The chorion is the outer membrane of the foetus that surrounds the amniotic sac.

Subchorionic hematoma is a common cause of bleeding in early pregnancy.

Let's have a more in-depth look at this condition, and the risks it poses during pregnancy.

CAUSES OF SUBCHORIONIC BLEDDING DURING PREGNANCY

The causes of subchorionic bleeding are not fully understood.

It is believed to occur when the placenta gets detached (fully or partially) from the uterine wall.

Some risk factors include:

• IVF Pregnancies: Studies have found that the the frequency of subchorionic hematoma is high in IVF pregnancies and frozen-thawed embryo transfer.
• Age: Women above the age of 35 are more likely to develop subchorionic hematomas.

Do note that, bleeding from subchorionic hematoma is usually harmless. Symptoms usually resolve on their own and it is rarely a sign of a miscarriage. With treatment and close monitoring, women can go on to have perfectly healthy pregnancies.

SYMPTOMS OF SUBCHORIONIC BLEEDING DURING PREGNANCY

Symptoms of subchorionic bleeding during pregnancy are:

• Spotting
• Vaginal bleeding
• Pelvic pain and cramping, especially in cases of heavy bleeding
• Dizziness

Bleeding caused by a subchorionic hematoma can range from a heavy flow with clots to light spotting. Sometimes there is no bleeding at all.

In fact, some women don't experience any symptoms at all, and only find out about the condition during a routine ultrasound examination.

CAN SUBCHORIONIC HEMATOMA HARM THE FOETUS?

Complications posed by subchorionic hematomas depend on the size of the hematoma and when they are detected during pregnancy.

In most cases, subchorionic hematoma resolves on its own. Hematomas that are detected early on in the first trimester and those that don't grow in size are less problematic.

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Small hematomas on the surface of the placenta cause less issues than those that develop under the placenta or behind the foetal membrane.

Hematomas that happen towards the end of the first trimester or early second trimester can cause the placenta to pull away from its site of attachment on the uterus. If more than 30 per cent of the placenta becomes dislodged, it could cause the hematoma to grow even larger, and increase the risk of preterm birth and miscarriage.

Studies have found that subchorionic hematoma can increase the risk of pregnancy complications, like miscarriage, preterm labour, placental abruption, and premature rupture of membranes.

The risk is higher in the first 20 weeks of pregnancy. Complications also depend on the size of hematoma, gestational age, and the mother's age.

It is thus important that you let your doctor know right away if you experience vaginal bleeding during pregnancy.

DIAGNOSIS AND TREATMENT OF SUBCHORIONIC BLEEDING DURING PREGNANCY

If you notice vaginal bleeding at any point of your pregnancy, consult your doctor immediately. Your doctor will usually ask for an ultrasound scan.

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Either a transvaginal or an abdominal scan is done to determine the size and position of the clot, the actual amount of bleeding and the site of the collection of the blood.

Your pregnancy will be monitored closely to check if the the clots are resolving naturally or if they are still growing and pose risks.

If the chances of miscarriage are high, some doctors will use estrogen and progesterone to slow or prevent further hemorrhaging. In rare cases, the doctor may recommend blood thinners to bleed the clot out.

CARING FOR YOURSELF WHEN YOU HAVE SUBCHORIONIC BLEEDING DURING PREGNANCY

• Keep track of how heavy your bleeding is, the colour of the blood (brown, dark or bright red), if it gets heavier or lighter, and how many pads you are using. Go for your ultrasound check-ups regularly.
• Don't use a tampon or douche when you have bleeding
• It is advised to avoid strenuous activity, heavy lifting, or excessive exercise. Also avoid standing for long periods of time.
• Your doctor may advise you to take bed rest and avoid sex until the hematoma dissolves and disappears.
• Stay well hydrated, and eat fibre-rich meals. This can help in preventing constipation and excessive strain that can cause bleeding.

Get immediate medical attention if:

• There is sudden, severe pain in your belly or pelvis.
• You have severe vaginal bleeding.
• You are dizzy or light-headed, or you feel like you may faint.
• You have new or worse vaginal symptoms, such as pain in the vaginal area, itching, or a discharge.
• You have a fever.
• You think you may have passed tissue. Save any tissue that you pass and take it to your doctor as soon as you can.

This article was first published in theAsianparent.