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  • Case 2 - A Patient with a Subchorionic Hematoma Presents with Early Vaginal Bleeding

  • from Section 1 - Antepartum (Early Pregnancy)
  • Edited by Peter F. Schnatz, The Reading Hospital, Pennsylvania, D. Yvette LaCoursiere, University of California, San Diego, Christopher M. Morosky, University of Connecticut School of Medicine, Jonathan Schaffir, The Ohio State University College of Medicine, Vanessa Torbenson, Mayo Clinic Alix School of Medicine, David Chelmow, Virginia Commonwealth School of Medicine
  • Book:
    Pregnancy Complications
    Published online:
    08 April 2025
    Print publication:
    01 May 2025, pp 4-6

  • Summary

    Subchorionic hematoma is a common ultrasound finding in pregnant patients presenting with first-trimester bleeding or found on routine pregnancy ultrasound. Patients may be asymptomatic or have light vaginal bleeding not associated with pain or cramps. On ultrasound, a subchorionic hematoma appears as a crescent-shaped fluid collection between the chorionic membranes and the decidua. Studies show that this finding can be associated with a higher risk of miscarriage and pregnancy loss, preterm delivery, and preterm premature rupture of membranes. No intervention has been shown to reduce this risk. This finding can be associated with stress and anxiety to the expecting parents. The cause is not well understood and most resolve spontaneously by the second trimester. Management for small subchorionic hematomas is conservative with counseling and follow up at routine visits. Larger subchorionic hematomas can be followed more frequently.