Intrauterine hematomas in pregnancy: everything you need to know

One in three pregnant women experiences blood loss at some point during pregnancy , especially in the first trimester. They can be caused by a minor problem or be a sign that something is wrong, but always, as is normal, they are a cause of great concern in pregnant women. One of the most common causes of bleeding, especially during the first months of pregnancy, is intrauterine hematomas in pregnancy .

What are intrauterine hematomas

Intrauterine hematomas are known as interdecisionotrophoblastic hematomas . They appear when small lakes of blood are produced inside the endometrial cavity, between the most superficial layer of the uterus and the tissue of the pregnancy.

It is something quite common in the first stage of pregnancy, however its cause is unknown. It is not usually accompanied by abdominal pain and bleeding can be variable (there may even be no bleeding). In any case, always before a loss of blood in the pregnancy it is necessary to go immediately to the doctor so that it evaluates the cause.

In general, intrauterine hematomas do not usually lead to pregnancy loss , especially when a heartbeat is observed. In most cases, with rest, the bruises are reabsorbed and disappear spontaneously, although if the bruise is very large it will take longer to disappear and the bleeding will be longer.

In the event of a hematoma, as a precautionary measure, the pregnancy is considered high risk and intensive monitoring is carried out to assess its evolution.

What if I have an intrauterine hematoma in pregnancy

Intrauterine hematomas are wedge-shaped or crescent-shaped between the chorionic (placental) tissue and the uterine wall.

Before a hemorrhage, the gynecologist performs an ultrasound to assess the condition of the fetus and check if the cause is a uterine hematoma. In the case of no bleeding, the hematoma is detected in the control ultrasound. The volume of the hematoma is measured using the formula of length (mm) x width (mm), which gives the size of the hematoma inside the uterus.

The prognosis of intrauterine hematoma is assessed taking into account two main elements: location and size.

A small or moderate hematoma without the company of other symptoms has a good prognosis and does not usually constitute a threat of abortion. As the pregnancy progresses, circulation normalizes and most bruises gradually disappear.

However, if abundant bleeding occurs accompanied by abdominal pain, the doctor will assess the threat of abortion and will indicate the most appropriate treatment, with rest being the best tool to prevent the hematoma from continuing to grow.

If the hematoma is large and located in a compromised site, it may be related to complications in pregnancy such as a detachment of the placenta or premature rupture of the bursa , which can lead to miscarriage or premature delivery in later gestations.

Types of bruises in pregnancy

Depending on where the hematoma is located, they can be classified into:

  • Subchorionic hematoma : it is the most common type, it is located between the chorion, which is the outermost membrane that surrounds the gestational sac, and the endometrium, which corresponds to the innermost layer of the uterus.
  • Retroplacental hematoma : it is located between the uterine wall and the placenta. It is associated with placental abruption, which is usually the most common cause of bleeding from the second half of pregnancy.
  • Subamniotic hematoma or preplacental hematoma : it is the less frequent type. The accumulation of blood does not affect the insertion of the placenta.

Many women suffer blood loss in pregnancy . As we said before, they are always a reason for consultation. If the doctor detects an intrauterine hematoma it is important to follow his instructions, which will surely be absolute rest, sexual intercourse and in some cases, progesterone forbidden.

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