Subchorionic bleed? And what does this all mean?

Patient

Q:
I am having a hard time getting a straight answer from one of the several midwives I see at my doctor's office, which has left me frustrated, to say the least. Some background... I had a miscarriage while being treated at another practice over a year ago. I have four healthy children prior to this miscarriage and no history of miscarriage or infertility. I am currently 13 weeks 5 days pregnant. At 7 weeks, I had an ultrasound to determine dating... we had a rough idea based on when I tested. They told me the baby was measuring at 6 weeks and a few days and that there was a subchorionic bleed and that I was having a miscarriage. I had experienced no vaginal bleeding or cramping and I was shocked to hear this news and absolutely devastated. They did a blood draw and sent me home with hugs and an "I'm sorry." Fast forward to three days later, my numbers are incredible and they schedule me for a follow up ultrasound where baby measures right on track (it caught up from where it should have been the first time, so they said the first US was off by a couple days, which happens) and bleed is still there. Still no vaginal bleeding or cramping. They tell me "guess we were wrong" and schedule my next appointment as usual. Way to throw me off... I go in for that appointment and they schedule me for a 12 wk ultrasound for NT and to check the clot. Baby is still measuring on track with a strong HB and the clot has moved away from the placenta, which is fully attached, and is now pooled down by my cervix. I wanted to know if this does sound like a subchorionic bleed, what I can expect, and what my chances of a successful pregnancy are? Whenever I get my hopes up, I feel like someone or something knocks them down. I have still not experienced any vaginal bleeding or spotting and my husband and I have chosen to abstain from sex until we know what is going on, just to be safe. I have four kids I take care of full time and of course this involves lifting them occasionally (smallest child is 24 lbs) like in and out of the car or tub. I get mixed reviews on what is safe and whether or not I will even be able to carry to term, etc. Please give me any advice or information that would be necessary at this point based on what I have told you, because my midwives are certainly not being very helpful. Thank you.

Doctor

A:   I realize the concern about this diagnosis. Let me reassure you that a Subchorionic hemorrhage is a common complication of pregnancies and is just the accumulation of blood between the layers of the placenta.
 
This hematoma generally is reabsorbed by your body, also sometimes it could bleed through your cervix but that is not too common. A subchorionic hematoma would not increase your chances of miscarriage alone, however since you already had a miscarriage before; this is a risk factor for developing a new miscarriage
 
The only treatment left is to follow up the development of your pregnancy that apparently is doing well, frequent ultrasounds in the first and second trimester would be needed to evaluate for changes in your clot size, a risk for miscarriage can only happen if the clot increases in size. I would suggest you to relax, avoid intense exercise, take your pre natal vitamins and comply with your follow up visits. I wish you a successful pregnancy.

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