Chorionic hematoma

A Chorionic Hematoma, also known as a subchorionic hemorrhage or bleed, is a form of bleeding that occurs between the chorionic membrane surrounding the embryo, and the uterine wall. It is the most common sonographic abnormality detected in the first trimester of pregnancy and can lead to complications such as miscarriage and premature labor.

Causes

The exact cause of chorionic hematoma is not well understood. However, it is thought to result from the separation of the chorionic membrane from the uterine wall, causing blood to pool between these two layers.

Symptoms

• Many women with a chorionic hematoma do not experience symptoms. However, in some cases, it can present with:
• Vaginal bleeding: The bleeding can range from light to heavy and may be accompanied by abdominal pain.
• In severe cases, there may be signs of pregnancy loss, such as cramping and backache.

Diagnosis

Chorionic hematoma is typically diagnosed through ultrasound imaging, where the hematoma appears as a hypoechoic (dark) crescent adjacent to the gestational sac.

Treatment

The management of a chorionic hematoma depends on its size and the presence of symptoms. In many cases, small, asymptomatic hematomas may resolve spontaneously without treatment. For larger hematomas or those causing symptoms, bed rest or pelvic rest may be advised.

Prognosis

The impact of a chorionic hematoma on pregnancy outcomes depends on the size of the hematoma and the gestational age at detection. While small hematomas often resolve without issue, larger ones may increase the risk of pregnancy complications such as miscarriage, premature labor, and placental abruption.

See Also

• Gestational sac
• Ultrasound
• Miscarriage
• Placental abruption

References

• Nagy, Sándor; Bush, Melissa; Stone, Joanne; Lapinski, Robert H.; Gardo, Sándor (2003). "Clinical significance of subchorionic and retroplacental hematomas detected in the first trimester of pregnancy". Obstetrics & Gynecology.
• Tower, Clare; Regan, Lesley (2001). "Intrauterine haematomas in a recurrent miscarriage population". Human Reproduction.
• Pedersen, Nina G.; Figueras, Francesc; Wojdemann, Karen R.; Tabor, Ann (2006). "Clinical consequences of first trimester vaginal bleeding". Ultrasound in Obstetrics & Gynecology.

External Links

Subchorionic Hemorrhage - American Pregnancy Association Chorionic Hematoma - Radiopaedia Chorionic Hematoma - Medscape

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