QuestionAt 13 wks 1 day I suddenly began bleeding profusely (went through many pads in just a few minutes). At the OB, u/s showed baby alive and well, but placenta covering cervix. My bleeding became so bad they admitted me for three days. I was home on bed rest for two weeks. During that time the bleeding stopped for only a few days before starting back up again, but darker. At 15 wks 2 days, u/s showed placenta up but a large blood clot covering cervix. Also, it showed that the amnion and chorion membranes were completely separated around the uterus.
I continue to be on bedrest, and I have been bleeding daily. I am using about three pads a day (but it has slowed down a good deal the past two days). My OB said that if the clot does not reabsorb and membranes fuse, then I would be at risk for preterm delivery.
My questions are:
1) How does the blood get through if my cervix is not dialated? (u/s showed it closed and long)
2) Since this occured during the 2nd trimester, is it less likely to resolve (I have read that most SCH's occur in 1st trimester and resolve by 12 wks).
3) Could the SCH be due to the placenta being over the cervix and not attached correctly?
4) Is is common to see the membranes separated with a SCH? I believe the sonographer mentioned that the clot has caused fluid to back up and kept the membranes from fusing.
Any other info you can provide, in addition to my questions, would be very appreciated. Oh, I am a 33 yo, healthy, non-smoker. I have delivered three full term babies and one 18 week dead baby (induced, cause of death unknown).
Thank you so much for your time and expertise.
AnswerAt your first sonogram, it appeared that the placenta was covering the cervical os. This is a placenta previa. Usually, as the pregnancy progresses, the placenta moves away from the cervix (due to the growth of the uterus), and there is no further problem. The problem with placenta previa is that you could bleed through the cervix if it starts to dilate and the placenta is situated over the cervix. However, if the placenta moves away, the problem is eliminated. However, you ALSO seem to have developed a "subchorionic bleed", which is a collection of blood between the membranes of the placenta. This usually does not cause any harm to the baby, but your clot seems to be preventing the fusion of the membranes. In itself, there should be no problem as long as the baby continues to grow and the FH is good. The clot should resorb little by little. Remember that the cervix is not air tight or blood tight and blood will seep out of the cervix even if has not shown any evidence of dilatation. The clot is as likely to resolve as those that form in the first trimester. It may take 8 weeks or so to resolve. I would suggest having serial sonography to track the resorption of the clot and assess fetal viability. At this point, just be patient and keep track of your bleeding. Don't worry.
