Subchorionic hematoma is the accumulation of blood below the chorionic membrane, which is around the gestational sac, and the wall of the uterus during pregnancy, and may not cause symptoms or result in vaginal bleeding.
Subchorionic hematoma, also called subchorionic hemorrhage, subchorionic bleeding or ovular detachment, is most common during the 10th and 20th weeks of pregnancy and is caused by the detachment of the chorionic membrane from the wall of the uterus.
Generally, subchorionic hematoma is naturally absorbed by the body, not requiring specific treatment, however, follow-up with the obstetrician and ultrasound examinations must be performed more regularly and follow the care recommended by the doctor.
Subchorionic hematoma symptoms
The main symptoms of subchorionic hematoma are:
- Vaginal bleeding, which can be light or heavy with clots;
- Cramps, especially if the bleeding is intense;
- Sensation of uterine contraction.
In most cases, subchorionic hematoma does not cause any symptoms and is discovered during routine prenatal ultrasound examination during pregnancy.
However, some women may experience light vaginal bleeding, and it is recommended to consult an obstetrician for an evaluation.
If the bleeding is intense and accompanied by cramps, you should go to the emergency room immediately.
Read too: Ovular detachment: what it is, symptoms, causes and treatment
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Does subchorionic hematoma harm the baby?
Subchorionic hematoma in most cases does not harm the baby, especially when the hematoma is small and can be absorbed by the pregnant woman’s body in a few weeks.
However, if the hematoma is large, greater than 25% of the area of the gestational sac or located in the retroplacental region, the maternal age is advanced or vaginal bleeding occurs before 8 weeks of gestation, there is a greater risk of miscarriage.
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How to confirm the diagnosis
The diagnosis of subchorionic hematoma is made by the obstetrician through ultrasound examination, and in the majority of asymptomatic cases, it is found accidentally during prenatal examinations. See the main prenatal exams.
If the woman is between 10 and 12 weeks pregnant, the doctor should also check the fetal heartbeat, which is considered normal between 110 and 160 beats per minute.
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However, when a woman presents symptoms, in addition to the ultrasound examination in which it is possible to check the size of the hematoma, the doctor must evaluate the history of previous pregnancies and history of sexually transmitted infections or pelvic inflammatory disease.
In addition, the doctor must perform a gynecological examination to assess vaginal bleeding, its quantity and the appearance of the cervix, in addition to an abdominal examination.
In cases of severe vaginal bleeding, the doctor must also order tests such as blood count, hemoglobin, hematocrit, blood coagulation panel, blood type and compatibility.
Possible causes
The exact cause of subchorionic hematoma is not completely known, but it is known that it occurs due to a partial separation of the chorionic membranes from the uterine wall.
Some factors can increase the risk of subchorionic hematoma, such as:
- Uterine malformation;
- History of recurrent miscarriage;
- Pelvic infections;
- History of infections or uterine trauma;
- Fertilization in vitro.
Furthermore, advanced maternal age, over 35 years old, also increases the risk of subchorionic hematoma, as well as a larger hematoma.
Read too: Pregnancy after age 40: risks and precautions
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How the treatment is carried out
The treatment of subchorionic hematoma must be carried out with guidance from the obstetrician, taking into account gestational age, severity of symptoms, hemodynamic stability, in addition to the size of the hematoma and its location.
Normally, for stable pregnant women, with minor vaginal bleeding and a stable fetus, ultrasound monitoring is recommended approximately 2 to 4 weeks after diagnosis, which is the time in which the hematoma can be absorbed by the body.
During this period, absolute rest is not necessary, but the doctor may recommend avoiding excessive exertion and sexual contact.
If the woman presents vaginal bleeding and has an RH negative blood type, an injection of anti-D immunoglobulin is recommended.
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In cases of large subchorionic hematomas, the doctor may recommend hospitalization.
How long does it take for subchorionic hematoma to go away?
The time for a subchorionic hematoma to disappear varies according to its size, and it may take a few weeks for a small subchorionic hematoma.
To find out whether the subchorionic hematoma has disappeared, an ultrasound must be performed, in addition to regular follow-up with the obstetrician, always following his recommendations.
Possible complications
The main complications of subchorionic hematoma are:
- Premature placental abruption;
- Part premature;
- Premature rupture of membranes;
- Early or late pregnancy loss.
Furthermore, subchorionic hematoma identified in the first trimester of pregnancy increases the risk of gestational hypertension in the third trimester of pregnancy.
In general, the risks of complications vary with the stage of pregnancy in which the subchorionic hematoma was identified, its size and location and associated risk factors, and should always be evaluated by the obstetrician to initiate the most appropriate treatment.
What is the difference between hematoma and placental abruption?
Subchorionic hematoma or ovular detachment is the accumulation of blood between the chorionic membrane and the wall of the uterus, occurring mainly between the 10th and 20th week of pregnancy and is generally absorbed by the body itself.
Placental abruption generally occurs after 20 weeks of pregnancy, being a serious condition that can put the life of the baby and the pregnant woman at risk, and it is recommended to go immediately to the emergency room for consultation with an obstetrician.
Read too: Placental abruption: what it is, symptoms, causes and treatment
tuasaude.com/descolamento-da-placenta
Source: www.tuasaude.com