Complications & Concerns Subchorionic Hematoma and Pregnancy Risks Condition Characterized by Partial Placental Detachment By Krissi Danielsson Krissi Danielsson, MD is a doctor of family medicine and an advocate for those who have experienced miscarriage. Learn about our editorial process Krissi Danielsson Medically reviewed by Medically reviewed by Meredith Shur, MD on April 20, 2020 Meredith Shur, MD, FACOG, is board-certified in obstetrics and gynecology, as well as a certified medical examiner. Learn about our Review Board Meredith Shur, MD on April 20, 2020 Print Verywell / Gary Ferster Table of Contents View All Table of Contents Causes Risk Factors Symptoms Complications Treatment Bleeding during pregnancy can be alarming but isn't always a sign of an impending miscarriage. Sometimes bleeding is a symptom of a fairly common type of blood clot called a subchorionic hematoma that's formed by the abnormal accumulation of blood between the placenta and the wall of the uterus. Why this happens isn't entirely understood, but there are several possible causes. Although there's nothing that can be done about a subchorionic hematoma, in many cases treatments wouldn't be necessary even if it existed. Under most circumstances, women who develop subchorionic hematomas enjoy otherwise normal pregnancies and go on to have perfectly healthy, happy babies. Causes The causes of subchorionic hematoma aren't fully understood. It's thought that in some cases, bleeding may occur when the placenta—the organ that forms during pregnancy to provide oxygen and nutrients to the developing fetus and also to carry away waste—dislodges fully or partially from the uterine wall. Another possibility is that when the fertilized egg implants into the uterine wall the attachment is abnormal in some way. A small number of women experience a phenomenon called implantation bleeding around the time of implantation. When Does Implantation Occur in Pregnancy? Risk Factors There are some suspected risk factors for subchorionic hematomas. Studies have found they're more likely to occur in pregnancies that are conceived via in vitro fertilization (IVF) or frozen-thawed embryo transfer, for example. Women who've already had one baby or who are older also appear to be more likely to develop subchorionic hematomas. While bleeding from a subchorionic hematoma can be alarming, it is rarely a sign of a miscarriage. If the hematoma is small, develops early in pregnancy, and is otherwise symptom-free, the chances of carrying your baby to term are good. Symptoms Bleeding caused by a subchorionic hematoma can range from a heavy flow with clots to light spotting to no bleeding at all, in which case the only reason the clot is discovered is that it shows up during an ultrasound. Vaginal bleeding is estimated to affect as many as one in four women during the first half of pregnancy and is a common reason for first-trimester ultrasonography. Some women also have some cramping, especially if the bleeding is significant. When Hemorrhage Is a Sign of Miscarriage Complications Hematomas found during the early part of the first trimester tend to be less problematic than those discovered later in the first or second trimester. And generally speaking, small hematomas on the surface of the placenta are far less concerning than those that develop under the placenta or behind the fetal membrane. Hematomas that don't grow also are less worrisome, but those that do may cause the placenta to pull away from its attachment site on the uterus. If more than 30% of the placenta becomes dislodged, it could cause the hematoma to grow even larger. This may set off a domino effect in which the membranes (amniotic sac) ruptures prematurely, leading to spontaneous abortion. In fact, research has found that subchorionic hematoma can increase the risk of an array of pregnancy complications, including miscarriage, preterm labor, placental abruption, and premature rupture of membranes. The risk of complications is largely related to the size of the subchorionic hematoma, how far along the pregnancy is, and the mother's age. Treatment Once a subchorionic hematoma forms there's nothing a doctor can do about it. There's no treatment for these blood clots. However, they can be managed. If you develop one, depending on the location and size of the hematoma, your doctor may advise you to come in for regular follow-up exams. You would also be advised to avoid strenuous activity, heavy lifting, or excessive exercise. You may need frequent rest to prevent increases in blood pressure. Staying well-hydrated can help prevent constipation and the subsequent straining that might set off bleeding. In rare cases, a doctor may recommend blood thinners to bleed the clot out. If the chances of miscarriage are high, some doctors will use estrogen and progesterone to slow or prevent further hemorrhaging. When Pregnancy Bleeding Is a Medical Emergency Was this page helpful? Thanks for your feedback! Get diet and wellness tips to help your kids stay healthy and happy. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Family uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Asato, K., Mekaru, K, Heshiki, C., et.al. Subchorionic Hematoma Occurs More Frequently in in Vitro Fertilization Pregnancy. Eur J Obstet Gynecol Reprod Biol. Oct 2014;181:41-4. DOI: 10.1016/j.ejogrb.2014.07.014. Palatnik, A. and Grobman, W. The Relationship Between First-trimester Subchorionic Hematoma, Cervical Length, and Preterm Birth. Am J Obstet Gynecol. Sept 2015; 213(3):403.e1-4. DOI: 10.1016/j.ajog.2015.05.019. Tuuli, M., Norman, S., Odibo, A., et al. Perinatal Outcomes in Women With Subchorionic Hematoma: A Systematic Review and Meta-analysis. Obstet Gynecol, May 2011;117(5):1205-12. doi: 10.1097/AOG.0b013e31821568de.