Here is a common scenario. You have an early pregnancy ultrasound and your
doctor tells you that there is a collection of blood between the uterine
wall and where the pregnancy is implanted.
This is called a subchorionic hemorrhage or bleed. What
caused it? Can you prevent it or heal it? Does
having one mean you're going to have a miscarriage?
Stay tuned and i will answer all of these important questions.
Ultrasound is a valuable tool in early pregnancy.
Doctors can use ultrasound to identify women
who have a non-viable pregnancy or those who might be at greater risk for
miscarriage. Check out this video to see how.
Sometimes findings on ultrasound, however, can raise more questions than they
answer. The finding of a subchorionic bleed is one of those times.
When an embryo implants, it actually goes underneath the surface of the uterine
lining. The cells of the embryo are divided into those that form the fetus
and those that form the placenta. As the placenta starts to form,
blood vessels from the mother's uterus, called spiral arteries,
start to move into the placenta. Spaces start to form
in the placenta and they merge together with other spaces forming channels
like a sponge. This is all very normal. It is how the oxygen and nutrients get
to the placenta. Sometimes too much blood accumulates in
these channels and it pushes the placenta away from the
uterus. If these blood-filled spaces get big
enough, they can be seen on ultrasound and we call them a
subchorionic hemorrhage. If the blood pushes its way to the edge
of the placenta, it can find its way out of the uterus
and cause a woman to see vaginal bleeding.
Most of the time, these collections of blood will shrink
on their own and become so small that you can't see them anymore.
This could take anywhere from a few days to a few weeks.
In some cases, they may not go away completely
and can still be seen months later. Let's dispel
a few myths about subchorionic hemorrhage.
There is no evidence that having sex or exercising during pregnancy will cause a
subchorionic bleed. There is no evidence that bed rest will
make a subchorionic bleed go away more quickly. There is no evidence
that eating or not eating certain foods will make a subchorionic bleed resolve
more quickly. There is also no benefit for increasing
fluids. There is no homeopathic voodoo,
spells or remedies or any supplements that will make a subchorionic bleed go
away any faster. Don't throw away your money on any of
these scams - they do not work! The question I get
asked a lot is this: Does a subchorionic hemorrhage predict a
higher chance for having a miscarriage? The
quick answer is "maybe". In women who are having vaginal
bleeding, ultrasound can find a subchorionic bleed
about 10% of the time. However, they are also found commonly in
routine ultrasounds for women who are having no
complications. In the 40 years since subchorionic
bleeds were first identified, it is still unclear whether they are
more common in women who miscarry versus in women that do not. There have
been some studies that have tried to identify
if women who are identified with a subchorionic bleed have a higher risk
for miscarriage. These studies are difficult to interpret.
For example, when looking at the size of the blood
collection on ultrasound, different studies used different methods
to measure them. Some studies just measured the length of
the blood collection, others tried to estimate the size
relative to the size of the gestational sac.
These differences make it very difficult to compare these studies.
Other studies have also tried to look at the location of the bleed,
how far along the pregnancy was when the hemorrhage was diagnosed,
how old the mother was and whether a woman noticed
vaginal bleeding or not. To date there is no conclusive evidence that
any of these characteristics predict a greater likelihood for miscarriage.
Our InfertilityTV bottom line is this: subchorionic bleeds are a common finding
in early pregnancy. Although this can be a stressful scary
finding, most of the time they are going to
resolve on their own. There is no evidence that anything you
did or didn't do was the cause of this
collection of blood. There is no treatment for a subchorionic
bleed. You can continue your normal activities
and please please don't get conned into
buying any treatment or supplement it is a
waste of your time and money. In addition to hosting
InfertilityTV every week, I am a practicing physician.
If you would like to have a one-on-one consultation with me
by video, check out my website at ivf1.com
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