What to Know About a Subchorionic Hemorrhage in Pregnancy
An ultrasound is an exciting time to check on baby’s development and see their oh-so adorable features on screen, but it can sometimes be a stressful experience with surprising revelations. One potential complication that can be spotted during an ultrasound is a subchorionic hemorrhage.
If you’ve been diagnosed with a subchorionic hemorrhage, it’s understandable to have questions about what this means for you and the health of baby. The good news: Subchorionic hemorrhages often resolve on their own. Here’s what you need to know about the condition.
A subchorionic hemorrhage is a clot or bleeding that occurs between the wall of the uterus and chorionic membrane (the early embryonic tissue that’ll become the placenta), explains Michael Cackovic, MD, a maternal-fetal medicine physician at the Ohio State University Wexner Medical Center. It’s sometimes referred to as a subchorionic hematoma or subchorionic bleeding, notes the Cleveland Clinic, and it’s one of the most common causes of vaginal bleeding in pregnancy between weeks 10 and 20.
“It’s an ultrasound finding that we believe is evidence of the pregnancy chorion partially separating from the uterine wall,” adds Matthew Carroll, MD, assistant professor of obstetrics and gynecology at Baylor College of Medicine and Texas Children’s Hospital.
“I try to explain it to people this way: The placenta separates from the uterine wall later in a pregnancy. Subchorionic hemorrhage is a similar process but occurring really early—before we call the pregnancy tissue the placenta,” adds Damali Campbell-Oparaji, MD, associate professor in the department of obstetrics, gynecology and women’s health at Rutgers New Jersey Medical School.
Looking for a definitive reason for an identified subchorionic hemorrhage? Unfortunately, you’re not going to get one. “We don’t know what causes it,” Campbell-Oparaji says. That said, there are certain risk factors that are linked to this type of clot. According to Christine Greves, MD, a board-certified ob-gyn at the Winnie Palmer Hospital for Women and Babies in Orlando, these include:
- Pregnancy trauma (i.e. you were in a car accident or were hit in the abdomen)
- Vascular dysfunction
- Uterine abnormalities
- History of miscarriage
- High blood pressure
- In vitro fertilization (IVF)
Still, Carroll adds that most subchorionic hemorrhage cases are spontaneous and random.
This might sound very scary, but it’s reassuring to know that the majority of subchorionic hemorrhage cases resolve spontaneously, reiterates Cackovic. Of course, it’s also important to know that miscarriage is a possibility. “It’s been associated with early pregnancy loss,” Carroll says. “There also has been a smaller association between subchorionic hemorrhage in earlier pregnancy and preterm labor, premature rupture of membranes and pregnancy-induced hypertension.”
Keep in mind that these risks are also usually linked to the size of the bleed. If the clot is greater than 25 percent of the gestational sac, it can be more closely associated with pregnancy loss, Cackovic says. Fortunately, the early diagnosis of a subchorionic bleed doesn’t increase adverse outcomes after 20 weeks. So while it may be associated with early loss, research shows the miscarriage risk actually decreases after you hit the 20-week mark. On the other hand, if it’s spotted after that point, it may indicate a risk for preterm labor and birth.
Can a subchorionic hemorrhage cause birth defects?
It’s normal to wonder if a subchorionic hemorrhage can negatively impact baby in any way. While it’s linked to an elevated risk of miscarriage and preterm birth, Carroll says it’s not associated with birth defects.
Pregnant people can sometimes experience bleeding from a subchorionic hemorrhage, Greves says. The amount of blood varies though. “Rarely will someone have bleeding similar to a period,” Carroll says. “More likely, it’ll be minimal dark bleeding or spotting.”.
Still, most cases are asymptomatic—meaning, there are no signs, Cackovic says. It may just be diagnosed during a routine ultrasound.
How to distinguish between subchorionic hematoma bleeding vs. miscarriage
It’s understandable to be concerned about the risk of miscarriage if you have bleeding during your pregnancy. “We would do an ultrasound and see if baby is [alright] and then provide watchful waiting,” Campbell-Oparaji says. “For the pregnant person, that sometimes is still nerve-wracking.”
It’s true that the only way to definitively distinguish between bleeding from a subchorionic hematoma and bleeding from a miscarriage is to do an ultrasound, Cackovic says. “Ultrasound will provide reassurance with a good fetal heartbeat,” he says. “Ultimately, bleeding would be much heavier with a miscarriage.”
Again, a subchorionic hemorrhage is diagnosed with an ultrasound. “We monitor symptoms—the bleeding and cramping, if present,” Carroll says. “We also will repeat ultrasonography if there’s a worsening in symptoms.”
Typically, there’s no treatment for a subchorionic hematoma. Most cases resolve on their own in a few weeks. “I have seen resolutions in a week and as long as a month,” Cackovic says. “The chorion will ‘heal itself’ in those cases.”
According to Kendra Segura, MD, a a California-based ob-gyn, your doctor may suggest pelvic rest, meaning “no intercourse for at least two weeks following the episode of vaginal bleeding.” They may also suggest you refrain from strenuous physical activity, but Cackovic says that bed rest hasn’t been associated with better outcomes. It’s more of a wait-it-out situation. A follow-up subchorionic hemorrhage ultrasound may be scheduled to provide reassurance for both the patient and provider.
Can certain foods help heal a subchorionic hemorrhage?
Being told to wait and see can be hard, and you may have questions about whether you can do something proactively to help the situation. If a quick Google search has told you that certain foods can help heal a subchorionic hemorrhage, proceed with caution. The truth is there are no known natural remedies for a subchorionic hemorrhage. Experts say there’s insufficient evidence to suggest that supplements or a change in your diet will help resolve a bleed faster—or at all, for that matter. “People have a lot of questions, but there aren’t a lot of answers,” says Campbell-Oparaji.
No one wants to learn of any complications in pregnancy, but if you’re told you have a subchorionic hemorrhage, try not to stress. It’s very likely that everything will progress normally, and the bleed will resolve. In the meantime, hang tight.
Please note: The Bump and the materials and information it contains are not intended to, and do not constitute, medical or other health advice or diagnosis and should not be used as such. You should always consult with a qualified physician or health professional about your specific circumstances.
Plus, more from The Bump:
Michael Cackovic, MD, is a maternal-fetal medicine physician and clinical associate professor at the Ohio State University Wexner Medical Center. He earned his medical degree from Hahnemann University Hospital in Philadelphia.
Damali Campbell-Oparaji, MD, is an associate professor in the department of obstetrics, gynecology and women's health at Rutgers New Jersey Medical School. She earned her medical degree from Temple University School of Medicine in Philadelphia.
Matthew Carroll, MD, is an assistant professor of obstetrics and gynecology at Baylor College of Medicine and Texas Children's Hospital. He earned his medical degree from the Mount Sinai School of Medicine in New York City.
Christine Greves, MD, is a board-certified ob-gyn at the Winnie Palmer Hospital for Women and Babies in Orlando. She earned her medical degree from the University of South Florida College of Medicine.
Kendra Segura, MD, MPH, FACOG, is a Los Angeles-based board-certified ob-gyn, as well as an entrepreneur, author, motivational speaker and cast member of Bravo’s hit TV series Married to Medicine: Los Angeles. She earned her medical degree at Ross University School of Medicine in 2011 and completed her residency at Rochester General Hospital in Rochester, New York.
Cleveland Clinic, Subchorionic Hematoma, July 2022
StatPearls, Subchorionic Hemorrhage, July 2023
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