Sub amniotic haematoma

[Muststopeating]

Hi. I posted yesterday and didn't get a response but have now done more research and spoken to the midwife to get more information.

It turns out the 'blood clot' discovered at my 20 week scan yesterday is actually a sub amniotic haematoma, which apparently means its inside the amniotic sac.

It is 6cm x 1cm x 1cm and is where the cord joins the placenta, so is likely the result of the cord separating slightly from the placenta. At the moment though it seems the cord is continuing to function.

I can find so little information about this specific issue, and the examples I can find on mumsnet are subchorionic haematomas, which occur outside the sac and do often result in bleeding.

From what I can understand in this case, it may just resolve itself and heal (though I am now at increased risk of retained placenta, which I can cope with , I've had it before and by that point I have a safe baby). It may rupture inside the sac which doesn't sound great, but I can't find anything that says what the consequence of that would be. I think worst case scenario is that it continues to grow and could separate the cord further, which would obviously be really bad.

The baby was measuring slightly on the small side but nothing concerning as I'm not huge and I've had one big baby and one smaller baby but both within the boundaries of average.

I am booked in for a growth scan and consultant appointment in 4 weeks.

Has anyone had one of these and can share their experience, even if it wasn't a good outcome?

Anyone? Please! Any experience at all would help me so much.

Sorry... going to keep bumping on the off chance someone has experienced this. Seems to be ridiculously rare and I'm desperate for some perspective on the prognosis.

What a fright for you! Have you heard any more from your consultant, or whoever was made available for extra questions? Are you under the high risk team now?

I had a big SCH which did heal, so I would imagine in your case healing could happen. Many of your kind, it appears, are only diagnosed after the birth, which is a good sign. I'd imagine you'll have extra monitoring.

They must be fairly confident if the gap between scans is 4 weeks.

Thanks so much for replying. I haven't got anyone except the normal midwife team to talk to yet, but imagine the consultant will put me on red pathway when I see them (unless, fingers crossed, it heals). The midwife I did talk to to get more information about type/size etc was fab but even she had to look it up. She wss incredibly kind, patient and couldn't have been more sympathetic - wish I could have her all the time.

Yes, from what I can find they aren't normally found until after delivery, but they also believe the majority of cases are caused during labour & delivery due to traction on the cord. Thus the cord coming away during pregnancy like this seems to be very unusual. They seem to be very different to SCHs, although i think the watch and hope treatment plan seems to be similar.

The few (and I do mean just a handful) of cases that have been studied seem to have had a bumpy ride but a good outcome.

I had been wondering if I needed to prepare myself for the worst and I think not being able to find anyone that had been through it was making it harder. But I've now convinced myself that I just need to get through the next few weeks. Hopefully it will have started to shrink, but if not by then I will be 24.5 weeks and as long as I'm closely monitored there will be options if things aren't going in the right direction. And I'm very fortunate that this baby is a kicker/wriggler so I get a couple of reminders each day that he/she is still okay.

I'm also trying to remind myself that there are many people who find themselves with much worse news at the 20 week scan.

Fingers crossed for you, while it may be tough waiting that really is all you can do at this stage, enjoying those little wriggles and kicks!

I'm going to keep this thread up to date in case anyone else needs it later.

I have just had my first growth scan at 24 weeks. I didn't see a consultant, because although I was supposed to, there was a mix up with which hospital to book me at and no consultants on today.

Anyway, the sonographer grouped sub amniotic hematomas together with SCH's. She said nothing will be actively done, they will just keep a closer eye on the baby. Unless baby stops growing or slows down centiles or the cord doppler indicates a problem then we just keep going. (I had thought I'd get a doppler today but apparently they don't start those until 28 weeks).

Baby is between 44th & 50th centiles for all their measurements, which is great (and as expected given size of previous babies and size of DH & I). The hematoma has potentially grown/stretched out with the placenta, but the sonographer seemed largely unconcerned. It is apparently encased within the placenta which is a better option than if it weren't. She is going to show the images to the Consultant tomorrow but doesn't think they'll want to see me while the baby's growth looks okay.

I have spent the last 4 weeks wondering if I needed to prepare for not having a baby at all but there is nothing today that indicates that. I guess there is still a risk that growth will slow down or the cord/placenta will start to struggle and I'll have to deliver early but again nothing of any concern at the moment.

Hi, @Muststopeating my partner has a SAH aswell, 15 weeks pregnant. Really hard to get any info on this. How has your pregnancy gone since your last post?

Hi. Glad you reached out, it is a scary time.

So my experience has been very positive. I am now 34 weeks and baby is absolutely fine. I had growth scans at 28 weeks and another last week. Baby is tracking absolutely perfectly along the 50th centile. They can no longer find the SAH and believe it has resolved. Everything looks great and I have been discharged from the Consultant care and can give birth in a community MLU if I'd like to, no further concerns.

I never had any bleeding and had it not have been found at the scan I would never have known anything was wrong. Baby has been incredibly active throughout and gives me lots of reassurance.

By the time I finally saw a Consultant the hematoma had already resolved so I never got to grill them about probable outcomes etc because it had all become irrelevant. Certainly, none of the midwives I have seen have ever seen an SAH specifically and they all just refer to SCH. I did ask the Consultant about the concern that the cord had separated (as I also have a history of retained placenta so although baby seemed fine I was worried about how best to plan for the 3rd stage). He said that the cord is living tissue so has almost certainly healed itself, otherwise baby wouldn't be doing so well.

The treatment plan seems to be identical to a SCH, basically monitor and keep a closer eye on growth, make a plan if things aren't going as expected but otherwise continue as normal. In other words it is a horrible time of wait and see.

Hopefully soon I'll have a healthy baby in my arms and will try to post back to let you know. I really hope things go well for you and that I've given you some reassurance. Let me know if you have any other specific questions and I am happy to try and answer them.

@Muststopeating really glad your pregnancy is going well from your last post!

We have seen consultant who seemed positive, which gave us a lot more reassurance. Just hoping it resolves or doesn't get bigger. We have 4 weekly scans booked in so just taking it scan by scan.

My partner had one bleed and passed a small amount of tissue at 10 weeks which led us to find out about it. For 4 weeks we thought it was a SCH and read loads of stuff on it but consultant confirmed SAH. No bleeding since (which is good!). Baby is also perfectly fine and active which further reassures us so far.

Will pop back up if we have any questions for sure :)

Hi @Muststopeating

Just a quick update, bleed has reabsorbed. Everything looks normal in the latest scan! We are so relieved. Fingers crossed it remains this way. 18+4 today.

Hope your pregnancy has went well these last remaining weeks.

@aldrichb sorry I missed your update. Great news!!! Hope everything is still okay.

I am currently snuggled up with my perfectly healthy 5 week old baby. Absolutely no problems at all with either the delivery or our baby. She is perfect.

Good luck with the rest of the pregnancy!

Hey,

I'm really glad this turned out positively for you!

We had a scan at 8 weeks due to previous bleeding, (only one episode at 5 +6). They said that the baby at the 8 week scan was the size it should be and had a heartbeat, but said I had a subamniotic haemotoma too. They do said it was 'significant' but when I asked for the measurements it was 25mm x 11mm.
They were incredibly unhelpful at EPU and told us to 'prepare for the worst' as they 'really don't know' and 'it's in the hands of the gods' and basically told us to to wait and see if there's anything in 2 weeks.
We have to go back in 10 days for a repeat scan, praying there's a heartbeat and all is okay but I'm such a pessimist that I can't stop thinking it will all go wrong.
I'm really happy to hear all went okay with you and eventually resolved, fingers crossed it will be the same for me!
I've been driving myself insane trying to find stuff online about it, and as you said, most things I can see are ladies that have a bumpy ride but normally good outcomes, albeit sometimes deliver early.