Subchorionic hematoma
Background
- 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)
- Ectopic pregnancy
- Subchorionic hematoma
- First Trimester Abortion
- Complete Abortion
- Incomplete Abortion
- Inevitable Abortion
- Missed Abortion
- Septic abortion
- Threatened Abortion
- Gestational trophoblastic disease
- Consider when pregnancy-induced hypertension is seen before 24 wks of gestation
- Heterotopic pregnancy
- Implantation bleeding
- Molar pregnancy
- Non-pregnancy related bleeding
- Cervicitis
- Fibroids
- Implantation bleeding
Vaginal Bleeding in Pregnancy (>20wks)
- Emergent delivery
- Placental abruption
- Placenta previa
- Vasa previa
- Uterine rupture
- Preterm labor
- Vaginal trauma
- Placenta accreta
- Intrauterine fetal demise
Evaluation
Workup
- Pregnancy test
- CBC
- Type & screen
Diagnosis
- Typically diagnosed on pelvic ultrasound
Management
Disposition
See Also
External Links
References
- ↑ 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.
- ↑ Pearlstone M, Baxi L. Subchorionic hematoma: a review. Obstet Gynecol Surv. 1993 Feb;48(2):65-8. PMID: 8437776.