Background: Subchorionic hemorrhage is the most common intrauterine hematoma detected on ultrasonography in early pregnancy and is frequently associated with first- and second-trimester vaginal bleeding. Although SCH has been linked to adverse pregnancy outcomes such as miscarriage, preterm delivery, and neonatal complications, existing literature shows conflicting results regarding its true clinical significance. This uncertainty necessitates further prospective evaluations to better understand the maternal and perinatal outcomes associated with SCH and to guide appropriate antenatal counselling and management.
Methods: A prospective observational study was conducted over one year (May 2023–May 2024) at the Department of Obstetrics and Gynaecology, Government Medical College, Thrissur. A total of 157 pregnant women with singleton pregnancies and ultrasonographically confirmed subchorionic haemorrhage was included after excluding multiple gestations, molar pregnancies, bleeding disorders, uterine anomalies, ART pregnancies, and those with prior adverse obstetric history. SCH was classified based on size relative to the gestational sac into small (<20%), medium (20–50%), and large (>50%). Participants were followed throughout pregnancy to assess maternal outcomes (abortion, preterm delivery and term delivery) and perinatal outcomes (birth weight, APGAR score, NICU admission, and neonatal death). Data were analyzed using SPSS, with statistical significance set at p<0.05.
Results: Most cases (76.4%) were diagnosed in the first trimester, commonly between 8 and 13 weeks of gestation. SCH was incidentally detected in 58.6% of patients, while 32.4% presented with vaginal bleeding. Term delivery occurred in 68.2% of cases, preterm delivery in 15.2%, and abortion in 16.5%. No significant association was observed between SCH and overall adverse maternal or perinatal outcomes. However, vaginal bleeding and larger hematoma size showed a statistically significant association with increased abortion rates.
Conclusion: Subchorionic haemorrhage, particularly when detected incidentally and of small size, does not significantly increase adverse maternal or perinatal outcomes. However, the presence of vaginal bleeding and large hematomas is associated with a higher risk of pregnancy loss. Larger multicentric studies are recommended to further clarify these associations.
International Journal of Clinical Obstetrics and Gynaecology
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