So what the heck is a Subchorionic Hematoma anyway?

Basically, it’s a large pocket of blood in the uterus.  It’s unknown why or how they form.  There’s nothing a pregnant woman can do to either cause them or make them go away.  They just happen.  This isn’t exactly comforting news.  There’s no controlling them and there’s nothing the doctor can do, per se, about them.

“What is a subchorionic hematoma or subchorionic clot? The “bag of waters” within the uterus is composed of two layers, called the chorion and the amnion. The inner layer, closer to the baby, is the amnion. The outer layer, which is normally against the uterine wall, is the chorion. The term “subchorionic clot” or “subchorionic hematoma” describes a blood clot between the bag of waters and the uterus.”

I found a very informative article through a support group that explains what they are here.  It’s pretty interesting and it shows examples of what they look like, so please read the whole article if you have a chance.

So what does this mean for my pregnancy?

Wednesday, I was supposed to go see the perinatologist.  That morning, I suddenly realized they had never called to confirm my appointment.  I called their office and was told that not only was the appointment cancelled, but that I was the one who cancelled it!  I told them I’d never spoken to their office and had been told my doctor’s office the appointment had been for 9:00, not 8:00 like they said.  Ian had taken off work especially to take me to this appointment since they’d be doing the anatomy scan and it would be the first time he got a chance to look at the baby.  I even checked my phone records and there were no calls to or from their office.  They told me they didn’t have any openings and because I was still bleeding and hadn’t felt Sam move, I had to go see my regular OB.  I was furious.

Thankfully, my wonderful office was able to get me in that morning and do an ultrasound.  Again, we saw that Sam was growing perfectly.  He was jumping and jiving and kicking and punching.  The ultrasound tech, Allie, explained why I wasn’t able to feel him move.  There was no where for him to kick that wasn’t either the placenta or the blood clot.  When I asked her to measure it, I was shocked when she gave me an estimate of 11cm.  A normal, 18 week old fetus is 13.25cm.  That was almost the length of Sam and I’d hazard a guess that at its widest, it was 5cm.

Again, there’s not a lot of literature on SCHs and even less on second trimester SCHs, but scouring the internet and pregnancy forums, the largest measurement I could find that anyone’s provided is 6cm.  That’s incredibly disheartening.  The more blood, the more irritation, which causes contractions.  Contractions bring on labor.  The SCH has a way to drain, so hopefully, it won’t form a clot and cause placental abruption (which means the placenta detaches from the uterine wall and causes miscarriage).

I asked my midwife to level with me.  I know she was trying not to freak us out, but we were able to read between the lines.  They expect me to go into preterm labor.  She told me once I hit 20 weeks they will make every effort to stave off it off.  However, there’s no guarantee.  I can expect to continue bleeding throughout my pregnancy, possibly another massive bleed like I had at the end of November, as well.

They also don’t know where the bleeding is coming from.  As you can see from the above article, SCHs are part of the placenta, between the layers.  This bleeding is not attached to the placenta.  I may still be bleeding internally, as in the pocket of blood may be filling back up.  I won’t know if there’s blood flow to it or where its coming from until I see the perinatologist (January 4th).  If I’m now looking at a pocket of blood 11cm after all that bleeding (and I’m still currently bleeding), how the hell big was it before it burst?!

Anyway, this is where we are now.  I have a healthy baby and an unhealthy uterus.  I am on bed rest (here’s a pretty interesting article on the benefits of bed rest for SCH patients) and will continue to be monitored throughout my pregnancy and will update this blog as it goes along.  I’ve never been in the situation where I was hanging my hopes on reaching viability at 24 weeks, but that’s where we’re at.  I have 5 1/2 more weeks until I get there.

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