Subchorionic Hemorrhage in Pregnancy

A pregnant woman getting an ultrasound of her abdomen

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Any time that you have bleeding during pregnancy, it is cause for concern. While there are many reasons that you may have spotting or bleeding in pregnancy, most are harmless. A subchorionic hemorrhage may or may not be worrisome, depending on the size and location. 

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What Is a Subchorionic Hemorrhage?

A subchorionic hemorrhage, also called a subchorionic hematoma, is bleeding between the amniotic sac and the uterine wall. This can occur from the placenta disconnecting from the original site of implantation, resulting in bleeding of the chorionic membranes—the outer layer of the amniotic sac.

Many people, hearing the word "hemorrhage," imagine pools of blood and worst-case scenarios. But a subchorionic hemorrhage is usually not quite as drastic as it sounds.

Most people who experience this type of bleeding go on to have full-term pregnancies and deliver a healthy baby.

You are more likely to have a subchorionic hemorrhage if you are pregnant after in vitro fertilization (IVF) or a thawed embryo transfer. You may also have a higher incidence if you are pregnant with a baby that is not your first baby. Age can also be a factor.

How Common Is Subchorionic Hemorrhage?

Subchorionic hemorrhage happens in almost 2% of all pregnancies, but it is the cause of about 20% of all bleeding in the first trimester. About a quarter of pregnant people experience bleeding in the first trimester.

A subchorionic hemorrhage may cause bleeding that is visible, or you may only see it during an ultrasound done in pregnancy for a different reason. It can be varying in quantity from spotting to heavy bleeding. The blood can be pink, red, bright red or brown. If you are spotting or bleeding, your health care provider may use ultrasound to determine the cause.

Pregnancy Outcomes 

Any bleeding during pregnancy may increase the risks of complications. People who have a subchorionic hemorrhage are at an increased risk for miscarriage and preterm labor. However, the risk is dependent on the size, location, symptoms, and timing in the pregnancy. The larger the area of bleeding, the more likely you are to have a complication, though this is certainly not true for all cases. 

A Word From Verywell

Many people experience bleeding during pregnancy and go on to have healthy babies. If you are bleeding or spotting, contact your doctor or midwife, who will likely ask you about the amount, timing, and color of the blood you are seeing. You may be asked to come into the office to get checked out, or your practitioner may recommend rest and watchful waiting.

Your doctor or midwife can help you understand what your specific risk factors are as well as the likelihood that bleeding will cause problems in your current pregnancy. Routine prenatal care, certain prenatal tests, and good follow-up will be helpful.

5 Sources
Verywell Family uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Asato K, Mekaru K, Heshiki C, et al. Subchorionic hematoma occurs more frequently in in vitro fertilization pregnancy. Eur J Obstet Gynecol Reprod Biol. 2014;181:41-4.  doi:10.1016/j.ejogrb.2014.07.014

  2. Norman SM, Odibo AO, Macones GA, Dicke JM, Crane JP, Cahill AG. Ultrasound-detected subchorionic hemorrhage and the obstetric implicationsObstet Gynecol. 2010;116(2):311-315. doi:10.1097/AOG.0b013e3181e90170

  3. Naert MN, Khadraoui H, Muniz rodriguez A, Naqvi M, Fox NS. Association between first-trimester subchorionic hematomas and pregnancy loss in singleton pregnancies. Obstet Gynecol. 2019;134(2):276-281. doi:10.1097/AOG.0000000000003360

  4. Hendriks E, Macnaughton H, Mackenzie MC. First trimester bleeding: Evaluation and management. Am Fam Physician. 2019;99(3):166-174. 

  5. American College of Obstetricians and Gynecology. Bleeding during pregnancy. September 2019.

Additional Reading

By Robin Elise Weiss, PhD, MPH
Robin Elise Weiss, PhD, MPH is a professor, author, childbirth and postpartum educator, certified doula, and lactation counselor.