Understanding Uterine Hematomas in Early Pregnancy: Causes, Risks & What to Expect

Question
my daughter just got back from the emergency room. She is 9 weeks pregnant. She is bleeding and was told she has a hematoma in her uterus. Can this cause miscarriage? She is experiencing cramping and a little discomfort. An ultasound shows the baby is fine and the heartbeat is strong. can you tell me any more about this. Thank you

Answer
Dear Sherry,

This is called a subchorionic hematoma. A subchorionic hematoma is a collection of some blood within the layers of the forming placenta. It can dissipate and disappear on its own when the hematoma "resolves" itself by dissolving. Other times you can have some vaginal bleeding (slight) and sometimes it does not cause outward bleeding. Depending upon where the hematoma is located, sometimes there can be a bit of bleeding that does not ever reach the vagina, but gets reabsorbed by the body. The size of the hematoma can obviously affect the outcome. Her doctor would be able to tell her the size of the hematoma and whether this would be considered small or large.

With any pregnancy, there is a 15-20% risk of miscarriage. Having a hematoma does not significantly increase this risk. And about 20-30% of ALL pregnancies experience some degree of bleeding. Of those, about half will go on to have full-term pregnancies and half will miscarry in the the 1st 12 weeks. As a rule, bleeding can be a sign of miscarriage, but does not mean that miscarriage is imminent. Many years ago, before ultrasounds, we wouldn't have been able to see these hematomas and this would have been considered a "threatened miscarriage" only because of the bleeding. But, as I said, about half of all women who experience bleeding (no matter what the reason), will go on to have full-term pregnancies. There is really nothing you can do to cause or prevent a miscarriage from happening. It is very encouraging that the baby's heartbeat was strong!

I'm sure that the ER advised her that, since bleeding is present, she should avoid anything being inserted into the vagina - no tampons or intercourse are encouraged while bleeding. She doesn't need to be on bedrest, but she can definitely avoid heavy lifting and straining while bleeding also.

I hope this information has helped you and answered your question. Please don't hesitate to write again with any additional questions. I wish you and your family a happy Christmas season.

Brenda