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Dr. Andrew Rynne

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Is a small subchorionic hemorrhage near the sac during pregnancy a concern?

Answered by
Dr.
Dr. Prof. Kunal Saha

General & Family Physician

Practicing since :1954

Answered : 4372 Questions

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Posted on Sat, 3 Sep 2016 in General Health
Question: Good Evening,

I am currently 15 weeks and 5 days pregnant. I am diagnosed with PCOS and during the first trimester in week 7 i had a subchorionic hemorrhage which resolved by week 12, my body absorbed it. This week i got into a minor car accident and went to the ER as a precaution they informed me my endocervical canal was mildly dilated and contained a small amount of fluid. They told me the baby was doing very well with a hbm of 150 and growing well. The following day i followed up with my GYN and got a cervical evaluation done via transvaginal ultrasound at which time they told me i have a tiny subchorionic hemorrhage near the sac that they are hoping resolves. Is it a bigger risk since i am currently in the 2nd trimester and now getting this hemorrhage. do 2nd trimester hemorrhages resolve as well or do they pose more risk for possible miscarriage because of placenta abruption? Im hoping considering that they said it was teeny tiny that it won't cause much of an issue (I do find it to be weird that at the ER they confirmed no hemorrhage and the following day they indicated they found a hemorrhage) They also told me that my placenta was lying very low and was by my cervix they are also hoping that the placenta moves up if not i will have to get a c-section. Does this cause any other risk factors?

What is the prognosis that all will continue to go well considering all of these complications that i am truly hoping are insignificant and i am trying my very best to remain hopeful! Im so upset this subchorionic hemorrhage came back :(
doctor
Answered by Dr. Prof. Kunal Saha 59 minutes later
Brief Answer:
Pathophysiology explained

Detailed Answer:
Thanks for asking on HealthcareMagic.

I have gone carefully through your query and understand your concerns. A low lying placenta increases the probability of getting a bleeding. This is because the lower portion of the placenta lies very near the cervical opening. The placenta overlies the uterine wall and therefore the cervical opening. Therefore the underlying surface of a low lying placenta may get exposed through the cervical opening, thereby increasing the likelihood of a bleeding, especially during the turmoil of a normal delivery. However, The uterus gradually grows in size and the growth occurs in the lower zone. Therefore effectively the placenta moves up. Unless this apparent displacement is significant, there is high chance of getting a severe bleeding during delivery and therefore a C-section is suggested.

I would insist you not to panic. There is a reasonable possibility that the rest of pregnancy would go fine. A C-section will manage the risk at delivery.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Prof. Kunal Saha 14 minutes later
Great thank you so much! What about the tiny subchorionic hemorrhage that has been found ? Does it pose more of a risk since it formed during the 2nd trimester? And is it of concern that it's so close to the gestational sac? Thankfully the baby's testing has been great but can this tiny hemorrhage cause a miscarriage during my 2nd trimester. Do small hemorrhages cause placenta abruption? (Im currently 15 weeks 5 days)
doctor
Answered by Dr. Prof. Kunal Saha 3 hours later
Brief Answer:
Stay aware. Consult your gynecologist urgently if you ever observe bleeding

Detailed Answer:
Thanks for writing back. The subchronic hemorrhage is likely to be due to the same mechanism (low lying placenta) as already discussed. It definitely poses an increased risk and may even lead to adverse outcomes like fetal growth restriction, premature labour or even fetal loss. But let us remain alert and not worry as worrying will only make things worse.

Small hemorrhages do not cause placental abruption, rather, small abruptions or separations of the placenta from the uterine surface lead to small hemorrhages. They are not a cause of worry, but bigger hemorrhages are what we are worried about.

The closeness to gestational sac is not a cause for concern.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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