Subchorionic Bleed in 2nd Trimester
QUESTION
Dear Midwife,
History: I am 28 years old. My husband and I went through infertility treatments to get pregnant, including one failed IVF and ending in a successful IVF. This is our first child and my first pregnancy.
Summary: Because of the infertility treatments we had ultrasounds every other week from weeks 4-10. I had dark discharge early in the pregnancy and it was credited to implantation bleeding. At the subsequent ultrasounds, no bleeding was found. This was around 6.5 weeks. I started seeing my regular OB at 12 weeks and continued with appointments where I heard the heartbeat every two weeks but did not have additional ultrasounds. Everything appeared to be progressing without incident until week 16. I was at work and in a matter of minutes I was soaked in blood. I went directly to the doctor's office and had an ultrasound that showed a bleed on "my side" of the placenta but that the baby was develping right on schedule. I was on bed rest for 5 days: the initial day of bleeding, two following days of bleeding as my regular period, and two days of lighter spotting. On my first day to work after bed rest I did have very slight spotting but did not have any additional spotting or bleeding. I had a follow up appointment at week 18. At the follow up ultrasound the bleed was still there. I was diagnosed with a Subchorionic Bleed, I have found online subchorionic hematoma/hemorrage. At 16 weeks the bleed measured 4.3 cm and at 18 weeks it measured 5.5 cm. The ultrasound still shows our daughter is developing as she should.
Questions: I am concerned 1) about the amount of bleeding I initially experienced, 2) that the subchorionic bleed didn't develop until the second trimester, and 3) the increase in size of the bleed from week 16 to 18. I have experienced some colored discharge since my last ultrasound but no active bleeding. I am in "educate myself" mode until my next follow up appointment at 20 weeks. I have been looking online and have only found 1 article and the rest have been blogs. Can you refer me to any resources? I want to know where to look to learn more. Is this size bleed considered small, medium, or large? What questions should I ask my doctor at my next appointment?
I appreciate any information you can give me. Thank you!
ANSWER
I am so sorry you are having to go through all this after all you did to get pregnant in the first place. I'm sorry I don't have a good resource to refer you to.
Basically, the short answer to your questions are that what usually happens in these cases is the hematoma will either drain, reabsorb or continue to build and eventually result in a miscarriage. A few seem to just stay there an cause spotting for the whole pregnancy. But there is nothing to either predict which will happen or to affect which way it will go, as far as I know.
As long as your baby "sticks" and continues to grow normally, you might very well end up with a normal pregnancy that goes to term, there is really no way to tell. You did the right thing to get immediate medical help if you start bleeding a lot, and to try to go about your business otherwise.
I know this is a difficult time, and I will be thinking about you and your baby. Hopefully, this will all resolve for the best soon.
-- Cynthia, CNM
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Cynthia Flynn
Cynthia Flynn, CNM. PhD, teaches in the College of Nursing at Seattle University and is President of the American Association of Birth Centers. She also practices midwifery at Valley Medical Center where she cares for pregnant and birthing women, and practices well-woman gynecology, family planning, and treatment of sexually transmitted diseases.
Cynthia founded Columbia Women's Clinic and Birth Center, where she took care of pregnant women and infants up to two weeks of age and attended both birth center and hospital births. Before Cynthia earned her CNM, she worked as a registered nurse in labor and delivery and postpartum and is a certified Doula and Doula trainer.
Cynthia hosts a monthly "Ask the midwife" chat as well as answers questions via our expert section.
Listen to Cynthia live on Pregnancy.org Live: Before, During and After.
