SCH

Every time I visited the Dr when I was pregnant he would say a word, a diagnosis that explained my condition, it started with a C but I could never remember it when I got home or when I tried to explain to others what I had. So the other day out of curiosity and because I want to get pregnant again I decided to search the Internet for some more explanations about a blood clot in or near the uterus during pregnancy and I found the word, Subchorionic Hematoma, my Dr always called it a Chorion. When reading about it, it hit me hard how scary my situation with Harrison really was. I wanted to put a bit of information on here about what it was and how really if you are diagnosed with one during your pregnancy the chances are 1-3% that it will end like mine did.

The US above was of my little Harrison at 11 wks and 3 days. I have tons of US pictures in my almost 21 weeks of him in my womb. I went every other week sometimes every week to see the progress of the clots. As you can see, Harrison is in the middle and at the top are two large black masses almost looking like 2 sacs. That was my chorion and each time it was bigger, you can see in this US it was bigger than he was.

Years ago, when a woman presented with early trimester bleeding, doctors assumed it was an impending miscarriage. They had no other information to go on, but now with new technology and US's they have a better idea as to what is going on. That's what I thought was happening. I was over 9 weeks and bleeding heavily, heavily. I was horrified. So when I went in and they found a heartbeat and that everything was fine I was shocked.

A Subchorionic Hematoma is a gathering of blood between the membranes of the placenta and the uterus. A more technical name is the chorion. Some doctors will also just refer to it as a blood clot.

Causes of Subchorionic Hematoma

There is no known cause for a SCH but many researchers speculate that during egg implantation, the egg slightly separates or tears from the uterus causing a bleed. There is nothing a woman did or could have done to cause or prevent them. SCH occurs to pregnant women of all ages and races.

Of course I go over and over again in my head all I did around the time I got pregnant. I know I didn't do anything but its hard not to blame yourself or wonder what you could've done different. I went to Lagoon, a big amusement, roller coaster park we figure when I was about 5 weeks pregnant. I didn't know I was pregnant but of course now that I look back on it I did ride almost all the scary rides, you know the ones that say, don't ride if pregnant. My Dr assured me that did not cause this, but of course I can't help but blame myself.

Diagnosing Subchorionic Hematoma

Diagnosing a SCH is based on its symptoms and visualization via ultrasound scan. Many women visit the doctor or emergency department with the chief complaint of vaginal bleeding during early pregnancy. An ultrasound, either transvaginal or abdominal, would more than likely be carried out. During the ultrasound scan, the doctor or radiologist will locate the fetus and assess it’s current condition. Identifying a SCH by an untrained eye is difficult. The clot appears as a black mass within the uterus. It almost appears as if another placenta is present. Ordinary ultrasound images appear blackish with visuals of bone. After a visual of the blood clot is made, and it appears a woman is not having a miscarriage, the diagnosis of SCH is made.

Having a diagnosis of SCH instead of a miscarriage is probably a relief but having SCH comes with it’s own concerns.

I remember feeling relief when the Dr told me I had a Chorin. I was so glad that I wasn't miscarrying. I was told that in most cases the clot will go away on its own and I should be fine. But to take it easy.

Treatment of Subchorionic Hematoma

There is no formal treatment for this blood clot but each doctor is different. Some suggest that you can continue with your everyday activities while others may suggest taking it easy. Some physicians even suggest refraining from sexual intercourse throughout pregnancy and bed rest. Surgery is not an option. Straining and heavy lifting should be avoided- as such for a normal pregnancy.

Some doctors prefer a ‘wait and see’ approach while others choose to use medications. Blood thinners such as: aspirin, Lovenox (inj), Coumadin and Heparin (inj) are used in attempts to ‘bleed’ the clot out. Estrogen and Progesterone therapy is also sometimes used to aid in the development of the pregnancy.

I was never put on blood thinners and I doubt they would've down anything because every time I bleed really bad and passed clots I would go to the Dr and be so excited to hopefully see on the US that the clot was gone, but every time the Dr did it, he would say, it was bigger. I was on major restrictions from day one and eventually put on bedrest.

The current statistics for pregnancy loss with a SCH is 1-3%. This low percentage is related to large clots. Most pregnancies progress with no further complications. Most clots resolve on their own by 20 weeks of pregnancy. The clot either bleeds itself out or the body absorbs it. Isn't that sad, most resolve by 20 weeks, i had Harrison at 20 weeks 4 days.

Because by the time I got into my 3rd trimester my clot was not gone but bigger, I was placed on bedrest and told to take it easy. I was told that they were going to try and get me to 24 weeks for the chance of my babies survival to double. I was told I was at high risk for pre-term labor and I would most likely not make it to 30 weeks.

Women with SCH are at greater risk for placental abruption or abruptio placenta. Placental abruption is when the placenta tears away from the uterus. This is an extreme pregnancy complication that requires immediate medical attention. If the placenta separates from the uterine wall, the health of the fetus is in danger.

Due to the Chorion I was hospitalized due to blood loss and to keep a close eye on me and Harrison. I was told I would be there till I delivered and that they were going to do all they could to get me to 24 weeks. Well 3 days in the hospital and on full bedrest, I had not bleed the whole time I was there, then one day I had a subchorionic Hemorrhage that led to pre-term labor and a placental abruption, the clot got too big and made it almost impossible for the placenta to hold it and the baby. There was no way of ever knowing it would end the way it did. I always had total faith in my Dr and had my hopes up the whole time, I never thought in a million trillion years it would end the way it did. Even when I look back on it, there was never a day, even when I was hospitalized that I would lose Harrison or even come close loosing my life. When I lost Harrison my Dr had never had a SCH case end like mine. Even most of the nurses in my labor and delivery area that were taking care of me never thought it would end like it did, we were all shocked to say the least. There really was no way of knowing and now when reading up on this I realize he was right. That is why if I do get pregnant again the chances of that happening again are well, 0-none. I was the 1%.

SCH is a risk early in pregnancy because the clot itself can cause a miscarriage. The clot can release completely from the uterus and cause the fetus and placenta to miscarry. This was a worry at first but because the baby was always bigger than normal and had a heart beat they were pretty sure I wouldn't miscarry.

Women with SCH may experience intermittent periods of vaginal bleeding throughout their pregnancy. This experience would more than likely be a result of the clot ‘bleeding out.’ Blood is an irritant to the uterus and cramping may be accompanied with the bleeding. While seeing blood while pregnant can be very scary-it is very common with SCH.

I know this is a sad thing to write about but seeing as its almost Harry's 11 month I have been thinking a lot about him and about a new baby and what my future will hold. I have been terrified to get pregnant again and I know when I do it will be scary I am sure of that especially if I see one drop of blood but researching this has given me some hope, some insight into how rare my situation really was and I am hopeful. I cry as I write this that it really was so rare and why did it have to happen to me but I know it was for a reason. I love my baby and miss him. I opened his box today to get out the US pictures and just bawled seeing him and those clots inside. It was so sad that it happened. I have no pregnancy pictures of him in me other than the US and they are so precious to me.