Hematoma is a blood clot that forms when blood seeps out of the blood vessels in the particular localized area. Hematoma of pregnancy is also known as subchorionic hematoma. It occurs when blood clots between the walls of uterus and the chorionic membrane. Pregnancy hematoma is usually noticed in the early stage of pregnancy, it is more common during the first half.
In olden days when modern scientific instruments were not available, doctors believed bleeding during early days of pregnancy is the sign of impending miscarriage. However, now it is easy to detect and diagnose hematoma during pregnancy with the help of ultrasound machine. The clot appears as a dark mass in the womb. The size of hematoma depends on the amount of clotted blood.
If a hematoma is small in size, it may regress without causing any symptoms. If the hematoma is large or increases in size as days pass, there is risk of miscarriage, still birth etc.
What Causes Hematoma During Pregnancy?
Researchers still do not know the exact reason for formation of hematoma during pregnancy.
Women of all age and race can suffer from subchorionic hemorrhage. However the rate of its occurrence is less than 1% and therefore, bleeding during early days of pregnancy should not be always assumed as subchorionic hematoma. Studies indicate that the rate of miscarriage and other complications such as still births increases with advanced age of mother and the increased size of hematoma.
The prognosis is guarded when bleeding occurs in later weeks of first trimester and the beginning of second trimester. Usually if the size of hematoma is small, it resolves without harming the pregnancy or the fetus. Beside miscarriage, the other complication is retarded growth of fetus and premature labor.
Hematoma In Pregnancy Symptoms
Bleeding is the most prominent symptom of subchorionic hemorrhage. The amount of bleeding may vary from one woman to another. There may be slight spotting in some women, while bleeding may be heavy with expulsion of clots in few others.
Since heavy bleeding during pregnancy can also occur as a result of threatened abortion, it is necessary to consult a doctor and confirm the diagnosis. Besides bleeding, there may be associated pain and cramps in the lower abdomen.
In some women, subchorionic hematoma may be asymptomatic meaning without any presenting symptoms. In such cases the condition is only diagnosed when the doctor advises a routine ultrasound examination during pregnancy.
Treatment For Subchorionic Hematoma
There is no specific treatment to cure hematoma in the uterus during the time of pregnancy. Physicians normally advise the patient to take complete bed rest. However, some physicians are of the opinion that the patient can perform her routine daily tasks, but restrict lifting weights, or heavy strenuous activities. They also recommend refraining from sexual intercourse during this period till the hematoma is completely resolved.
Usually the treatment is not generalized and doctors treat the condition after evaluating the pregnant women. Some doctors may prefer conservative approach of rest and observation. While many others may prefer prescribing blood thinner to dissolve the clot. She is continuously monitored during this period for increase or decrease in the size of hematoma.
Sonogram test helps in detecting the size of the clot. Doctors also recommend drinking water in sufficient amount, at least 8 to 10 glasses per day. This is because dehydration can lead to contraction of uterus and irritate the fetus.