Subchorionic hematoma

Background

Placental anatomy.
  • Bleeding underneath the chorion membranes enclosing the fetus in the uterus
  • Most common cause of vaginal bleeding in patients who are 10-20 weeks by gestational age, make up ~11% of cases[1]

Clinical Features

  • Vaginal bleeding
  • Increased risk of pregnancy loss, particularly when amounting to 25% or more of the gestational sac[2]

Differential Diagnosis

Vaginal Bleeding in Pregnancy (<20wks)

Vaginal Bleeding in Pregnancy (>20wks)

Evaluation

An 8-week fetus associated with a small (less than one-third of the chorionic sac circumference) subchorionic hematoma (arrows).
An 8-week fetus associated with a large (at least two-thirds of the chorionic sac circumference) subchorionic hematoma (arrows).

Workup

  • Pregnancy test
  • CBC
  • Type & screen

Diagnosis

Management

Disposition

See Also

External Links

References

  1. Ben-Haroush A, Yogev Y, Mashiach R, Meizner I. Pregnancy outcome of threatened abortion with subchorionic hematoma: possible benefit of bed-rest? Isr Med Assoc J. 2003 Jun;5(6):422-4. PMID: 12841015.
  2. Pearlstone M, Baxi L. Subchorionic hematoma: a review. Obstet Gynecol Surv. 1993 Feb;48(2):65-8. PMID: 8437776.