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Case 53

Subchorionic Haemorrhage

Vaginal bleeding in early pregnancy

Ken Wong

This 37 year old female was 11 weeks pregnant by dates. She presents with vaginal bleeding.

Findings

An intrauterine gestation, with a crown-rump length of 43 mm which corresponds to dates, demonstrates a fetal heartbeat and movement on dynamic scanning.

A 4.8 x 7.4 x 4.4 cm subchorionic hemorrhage is seen along the anterior uterine wall. The cervix appears closed.

Diagnosis

Subchorionic Haemorrhage

Discussion

Subchorionic hemorrhages result from abruption of the placental margin or marginal sinus rupture. They are associated with a 50% fetal loss rate and, according to one paper, bleeds > 6 ml have a poorer prognosis.

References

Sauerbrei EE, Pham DH. Placental abruption and subchorionic hemorrhage in the first half of pregnancy: Focal and ultrasound appearance and clinical outcome. Radiology 1986; 160: 109-112.

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