Subchorionic Bleed: Symptoms, Monitoring, and What to Expect

Question
I was diagnosed at 10 weeks with a subchoreonic bleed measuring 1.3 cm. The baby was measuring fine and the heartbeat was 167.  The two u/s I had prior to this did not show the bleed and again the baby was measuring fine and the heartbeat was good. I am now 12 weeks and am still experiencing brown discharge this has been on and off for two weeks. I am very worried that it will enlarge rather then being reabsorbed. What are your thoughts? In addition I have heard about missed miscarriages happening and wanted to know how often those happen. I've always been told that if the baby's heart stops beating you will have physical symptoms.  I find myself stressed and can not wait to be into my second trimester.

Answer
Louisa,

First let me say congratulations on your pregnancy!

Subchorionic hematomas are actually fairly common in early pregnancy, and their effect on the pregnancy depends on when they appear, how large they are, and maternal age.

The best case scenario is a mother under 35, with a hematoma less than 20% of the size of the gestational sac and early in the first trimester.  Spotting and bleeding with a hematoma is normal.

Considering your hematoma measures 1.3 cm and at 10 weeks your gestational sac should be a minimum of 3.1 cm, puts the size of the hematoma at no more than 40% the size of the gestational sac (without knowing the measurement of your sac this is just a guess).

This would be considered a medium sized hematoma.  The chances are that the hematoma will get smaller and things will be ok.  Problems occur when the hematoma prevents the placenta from attaching correctly to the site of the bleed.  This is most common when the hematoma is large and has a large volume of blood.

As you probably know, a missed miscarriage is one where the baby's heart stops but the baby is not expelled from the uterus.  About 1% of all pregnancies end in a missed miscarriage, but most of the time when fetal death occurs there are signs of a miscarriage.

The only real way to calm your fear about a missed miscarriage is to request another ultrasound, which some providers will comply with and others will not.

The best thing that you can do is to try your best not to stress (I know this is much easier said than done.)  Unfortunately there is not much you can do but wait and see.

I hope this answered your questions!  If not, please let me know!

Good Luck!

Tandi