Heavy Bleeding in Second Trimester: Causes, Symptoms & What to Do

Question
At about 15 weeks, I started bleeding yesterday very heavily.  In a half hour, my underwear, pants, and car seat were soaked as I drove to the ER.  I had escalating pain for about an hour, then it went away, as did the bleeding.  I only passed one small-medium sized clot.  They did an ultrasound, and said the baby looked good (good heartbeat, good growth, well formed placenta).  There was a little bit of blood under the placenta, which they think might have been a hemorrhage.  No one, including my regular doctor, seems to want to tell me what my prospects are like for the rest of this pregnancy, but I am on bed rest for at least 2 weeks.  I am high risk from 2 prior miscarriages, but both of those were at 10 weeks.  I had low progesterone, which I took until 10 weeks.  Otherwise, this pregnancy has been reasonably uneventful.  What do you think my chances of carrying this baby to term are?  Are there any markers or milestones that should increase or decrease my confidence?  Friends are already talking about baby showers, and I'm just not sure I should let them make those plans at this time.

Answer
Dear Rhia,

It sounds like you are looking for a percentage when you ask what your chances are for a full-term pregnancy and your doctor is probably hesitant to give you a number because there is just no way to know with any kind of certainty. I know that isn't what you are wanting to hear, but there simply isn't.

It sounds like your bleeding MAY have been related to what we call a subchorionic hematoma. A subchorionic hematoma is simply a collection of blood within the layers of the developing placenta or between the placenta and the uterine wall. Many times, especially when small to moderate in size, these may cause some vaginal bleeding but will not cause any major complication with the pregnancy.

In the presence of a live embryo, subchorionic hematoma is the most common sonographic abnormality. In women whose ultrasound shows a subchorionic hematoma, the outcome of the fetus depends on the size of the hematoma, the mother's age, and the fetus' gestational age. Rates of miscarriage increase with advancing maternal age and increasing size of the hematoma.

The subchorionic hematoma often regresses, especially if it is small or moderate in size. Large hematomas, which strip at least 30-40% of placenta away from endometrium, may enlarge further, compressing the gestational sac and lead to further complications. So it really depends upon whether this is actually what your OB doctor diagnoses you with, how large it is, and whether it begins to decrease in size or increase in size.

If you don't feel comfortable with baby shower planning right now, I would simply suggest that you tell your friends that you would feel much better about waiting to have a baby shower until you are about 34-35 weeks along. If you don't want to go into details, you can use the excuse that then you will have a nursery more set up, etc,..

I hope this has helped you and answered your question. I wish you well!

Brenda