QuestionI am so glad I found you.....I really need more insight that what my doctor is giving me.
My name is Alicea, and I am 36 years old. I have never been pregnant before, and now having a difficult pregnancy. Before I ask my question, I need to let you know what has been going on. A few weeks ago, after finding out I was pregnant, but not seen a doctor yet.....I was in the shower @ 4:30am. I passed some big clots, one of which was about 3 inches in diameter. My sister was here, and she is a new labor and delivery nurse. We were both POSITIVE that I was having a miscarriage. Since the bleeding stopped, I went in to work that day, and there was no more bleeding. Then @ 10:00am the next day, I started bleeding ALOT. I was in a dark portacan, so couldn't see whether the baby came out or not. The force of the bleeding, and what felt like clots was fast and furious. I left work, and when I got home, noticed there was a clear mucousy fluid in the blood. At that point, I was able to get an emergency visit to a recomended OBGYN clinic, for DNC.
Well, they done ultrasound, and found a healthy heartbeat. I was TOTALLY ASTOUNDED!!!!! He put me on bedrest for a week, then I went back, and he said what I have is a subchronic hematoma. I feel so sure that there were twins, and I lost one, but the doctor says only that it is possible, and then dismisses it.
I have still been having spotting and mild bleeding. The doctor now has me going back in two weeks, instead of one, like in the begining. I know I should be excited about maybe being a mommy, but is really hard, since I don't know what the chances are of my carrying the baby to term.
In your experience, can you tell me if I was right about the twin.......or is this normal for subchronic hematoma?
AnswerDear Alicea,
Vaginal bleeding affects 25% of all women during the first half of pregnancy and is a common reason for 1st trimester ultrasounds. The incidence of subchorionic hemorrhage is 1.3% of all pregnancies. In pregnant patients with 1st trimester vaginal bleeding, the incidence increases to almost 20%. A subchorionic hematoma is simply a collection of blood within the layers of the developing placenta or between the placenta and the uterine wall.
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 increased size of the hematoma.
2nd trimester bleeding may also worsen the prognosis. The subchorionic hematoma collects between the uterine wall and the chorionic membrane and may leak through the cervical canal. Late in the 1st trimester and early 2nd trimester, the subchorionic hematoma may partially strip the developing placenta away from its attachment site. Therefore, the prognosis of patients with this type of hematoma is worse than the prognosis of patients with hematoma early in 1st trimester.
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.
If your doctor has seen/diagnosed the subchorionic hematoma via ultrasound, most likely this has been the cause of your bleeding. Your description of the events is not at all contrary to what would occur with a subchorionic hemorrhage. Did he say what the size of the hematoma was?
I assume he will be monitoring the size to see see if it is receding or enlarging. As long as you are simply spotting and not having cramping and heavy bleeding, I would not be concerned for now. There may come a point when you will have to be back on bedrest if the hematoma does not resolve itself.
I hope this information has helped you and answered your question. I wish you well.
Brenda
