Subchorionic Hematoma - Who monitors it? Support and advice please.

[iambex]

Hi all,

I was diagnosed with a Subchorionic Hematoma at 11 weeks after having an extremely heavy bleed and passing very large clots. After a scan at the EPU, miraculously, a heartbeat was confirmed but there is still a pool of blood there so it is expected I will continue to bleed.

The Dr said I could come back for a reassurance in a few days and I should wait for my 12 week scan -the following week.

For those who have had an SCH have you been referred to an obstetrician? From what I have read (mostly american stories) people seem to be monitored once they have one. I know that they can't do anything about them, but I would feel more confident if someone was monitoring the situation. I still have so many questions I want to ask that I didn't think of at the time.

I'm finding the whole situation so hard to deal with. I already have so much anxiety as I am a first time mum and had a miscarriage back in February.

I'd be so grateful for any thoughts, support or advice from anyone who has been through a similar situation.

Thank you xx

I had one at 7 weeks and wasn't monitored. Just told I might keep bleeding. Every time I bled I went to EPU and at 9 weeks Baby was ok and it was still there then at 11 weeks bled again and went back and again baby was fine and haematoma has gone. They either keep bleeding or get reabsorbed. They told me some stay all pregnancy. Is it fairly big? They weren't concerned for me as it was small and above the sac.

@Ginandtonic31 Thanks for your reply - Good to hear a positive story.

The haematoma is 2cm, which I know is small, but I'm not sure if the huge amount of blood I lost was from that one or if maybe I had another one (which is now gone)? The whole thing confuses me which is why I would like to speak to someone about it!

Ive had this as well, and epu have monitored me. I had a bleed at 7 weeks, was told I could bleed again, and I did a couple of days later and again at8 weeks, which was much bigger. But scan showed pregnancy ok, they scanned again 2 weeks later, everything was still ok, and they said would be checked again at 12 weeks, which is this week.
I’m not sure if it will be monitored ongoing, mine was bigger at 5cm, and at one point was bigger than pregnancy sac.
It is worrying, but don’t think there is much they can do.

Haematomas I believe are quite common in early pregnancy and often are a result of the way the egg implants into the uterus wall.

I had an early reassurance scan and she could see a small shadow of one but said it’ll either cause a minor bleed or be reabsorbed.

The risk with big ones is that they come away all at once and take the embryo sack with it.

I don’t know anything about bigger bleeds like what you’ve had, but would hope that if the sack is still there and the remaining haematoma area is quite small it’s not such a high risk anymore? I must say that the nhs aren’t always brilliant and giving you a lot of information, I’ve found the private scans I’ve had much more informative, but then I have paid for that service.

I had a big bleed at 14 weeks with clots too. I was basically told to take it easy while bleeding but theres not much you can do. If tge blood is brown its old blood, if its bright red go back as its fresh. Until 26 weeks in the uk they wont intervene on the nhs.

Just to add Im now more than 30 weeks - my dr said most stop on their own around 20 weeks, mine did too. Anecdotally i was told long car/train journeys and plane rides can make it worse (something about vibrations and air pressure) so thats worth keeping in mind. Good luck x

@Knittedkitten - Good luck for your next scan. I will go back to the EPU this week and have a scan and see where we stand.

@Ithoughtyouwere - That's interesting to hear its to do with how the egg implants. Thank you for your kind words - I'm really hoping i'm not high risk anymore, but the Dr I saw said that due to the amount of blood I lost, it could affect the baby, which really worries me.

@Smiler88 - Ahh its amazing you are 30 weeks! Thanks for the advice regarding long journeys and for the well wishes. My bleeding is now dark brown, I'm just worried about the potential for a further bleed.

@iambex I've got one at the moment and totally get your worry. Mine started a month ago with a very scary, bright red heavy bleed and huge clots. I was 13 weeks. Since then, I have continued to bleed but it is all brown but I need to wear a pad at all times. It's particularly bad if I strain eg a poo (sorry!) but I've upped my fibre even more to help this.
I've not had any scans as EPU said that the heartbeat was enough but I'm under the gynaecology unit at the hospital and can go for a heart beat check whenever I like.
My midwife had also been amazing and has allowed me to have regular appointments to check on things.
I'm hoping that at my next scan, they'll tell me more although it may be passing now.
I've not been told to do anything differently though but you'll get to know what causes you more bleeding and remember that it doesn't harm the baby at all.

I had one of these at around 6 or 7 weeks and wasn't monitored. It had resolved by my 12 week scan and DS is now a very healthy age 10. Good luck to everyone - it's a worrying time!

I have one which wasn’t diagnosed until 19 weeks after 3 days of red bleeding just beforehand, nothing in the early stages at all. I had an emergency scan on day 3 of bleeding (Doppler checks before this), my standard 20 week scan the week after and now have a scan with a consultant at 24 weeks to assess what it’s like then ( I’m currently 22 weeks). I’ve been told what monitoring I receive will depend on that scan but likely 4 weekly until the end of pregnancy.

For what it’s worth, it’s veru rare to have one which lasts the whole pregnancy. Most disappear by second trimester or the 20 week scan. I’ve been told to go back in for red bleeds but not anything else - touch wood, I’ve not had any heavy bleeding episodes since diagnosis. My SCH is 5cm and just above my cervix.

Oh, and I’ve been spotting brown since the bleed three weeks ago but it is starting to taper off - it only really comes back if I’ve overdone it the day before. I’ve put myself on pelvic rest and don’t really do anything strenuous.

I had one and bled from 6 to 16 weeks. I had lots of scans during at the beginning (with private IVF clinic) but then I think just one extra once I got past 12 weeks. It's horrible, annoying and scary but much more common than I realised. I had one NHS consultant appointment (who advised against taking a long haul flight) but no other interventions: My baby is now 7.

@muddypuddlejumping Thanks for sharing your story. It makes me feel less alone in this scary situation.

It's great to hear your midwife has been good, I wonder if I should give mine a call, as my next appointment with them isn't until mid October.

I really hope it hasn't harmed the baby - I'm just so worried as I lost huge amounts of blood and passed clots the size of packs of butter.

@ShoesJerry Great to hear a positive story! Thanks for your well wishes.

@Missmonkeypenny Sorry to hear about your experience, it's good you are being monitored now. Mine is also above my cervix - which I've heard is a good thing! Good luck with the rest of your pregnancy.

@Sarahduckobsessive Wow, it sounds like you had a really scary time, but a very good outcome. Thanks for the advice regarding flying, we were thinking of booking of a holiday before the end of the year, but with all that has gone on, I think we will stay UK based.

I wasnt monitored for my bleed at all but after 2 previous losses and the amount of blood I was loosing daily they said they'd scan me weekly if i needed it for my mental health. 3rd pregnancy after losses at 7 and 14 weeks I bled from 7-17 weeks bright red with huge clots. I had an extra chronic hemorrhage attached to sac think mine was about 3cm but got to 5cm. By 20 week scan it was gone completely. They are very common but absolutely terrifying. My 15 week old is currently asleep in my arms xx

I've just realised I go on holiday later this month's at 16 weeks. They couldn't see my heamatoma on a scan last week but I'm really scared about flying now. I will get them to really check everything at my scan on Friday.

@xJune88 I'm sorry to hear about your loses. It's lovely to hear you have a lovely little one in your arms - congrats!

Were your extra scans organised through your midwife?

@Ginandtonic31 I've flown with mine and it made no difference at all so please don't worry. No extra bleeding either.

@iambex I booked in to see mine so def do that as that's what they are there for!
My clots were very large too but a doctor told me it was the haemotoma coming away and smaller parts of the clot breaking off and passing (so gross! 😂)
Hope that helps.

That's reassuring @muddypuddlejumping I'm already worried because it's 7 hours!

I had one at 8 weeks. The sudden and heavy bleeding was terrifying.

I had one scan in the EPU to show everything was okay. Mine was down to one of the blood vessels in the placenta bursting. Apparently the concern was if more burst so caused issues with the placenta.

I didn't have any follow up. They said either the blood would re-absorb or I would get brown bleeding (I had brown spotting from then until about 11 weeks). They said to get referred back if I had any more red bleeding but otherwise that was it.

It is worrying but the important thing for now is to make sure you do get some rest.

I postponed the long haul flight but still flew short haul to Europe and it had no effect at all. I think the advice against long haul (more than 10 hours) was related to a) what would I do if I had a big bleed on a really long flight or b) having a big bleed while abroad and not having access to scans rather than the flying causing more bleeding.

@Sarahduckobsessive I personally don't feel 7 hours is long haul as I tend to travel mainly long! We are going to Dubai and the hospitals tend to be pretty good so I'm not worried when there. The haematoma appeared to have gone last scan but I think im more worried about flying in general causing damage!

Thankyou it's the best thing ever. So tiring but so worth it all. My scans were through epu direct I also paid for alot of private ones after 20 weeks 🙈 and then had growth scans and doppler ones for reduced movements near the end, I was induced due to reduced movements and she was poorly when she was born so glad I listened to my instinct too x

Ironically, I had my first bleed in three weeks last night and went back up to the hospital. Same thing again, cervix closed so no issue there, baby very happy - it’s just this sodding bleeding! They’ve now said that every time I go in with a bleed, I’ll need to stay for 24hr for observations. I’ll also be having bi weekly scans because apparently SCH in second and third trimesters can cause growth issues. I’ll also be consultant led and have to have manual removal of my placenta after birth as I’m at risk of haemorrhaging....

So long, low risk pregnancy and serene water birth!