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Pregnancy loss & early Call your provider

Subchorionic hemorrhage

Also known as Subchorionic hematoma, SCH. First trimester and early second trimester, roughly weeks 9 to 20.

If a scan turned up a subchorionic hemorrhage, it means a small pocket of blood has collected between the pregnancy's outer membrane and the uterine wall, where a little area separated. The word sounds alarming, and bleeding alongside it is frightening, but this is a common finding, and most of the time it heals on its own and the pregnancy continues. Size matters, and so does the bleeding, which is why your provider will ask.

Know the warning signs When to call a provider
How common
A common finding
One of the most frequent causes of first-trimester bleeding; found in a few percent of routine scans and far more often when there is bleeding.
When
Weeks 9 to 20
Most often diagnosed in the first trimester or early second.
Urgency
Call your provider
Any bleeding in pregnancy warrants a call; heavy bleeding is urgent.
Outlook
Most resolve
Small hematomas usually heal on their own and the pregnancy continues.

Understanding it

What is subchorionic hemorrhage?

A subchorionic hemorrhage, also called a subchorionic hematoma, is a collection of blood that forms when the chorion, the pregnancy's outer membrane, partly separates from the uterine wall and blood pools in the gap. On ultrasound it appears as a crescent-shaped pocket beside the sac. It is one of the most common findings when someone bleeds in early pregnancy, and it also turns up by chance in people with no symptoms.

The word hemorrhage frightens people, and the reality is usually far gentler. Most, especially small ones, are reabsorbed over the following weeks, the way a bruise fades, and the pregnancy is unaffected. Many people who have one go on to a completely normal birth.

That said, size and timing matter. A larger hematoma, and one found very early, carries a somewhat higher miscarriage risk than a small one. That is why your provider grades the size and often repeats the scan to confirm it is shrinking, not growing. Any bleeding you see is usually old blood draining from the pocket, and it can look worse than it is.

No medicine dissolves a subchorionic hemorrhage; the body clears it. Care is watchful: confirming the pregnancy is healthy, following the size over time, and knowing the specific signs, like heavy bleeding or severe cramping, that mean you should be seen right away.

Symptoms

What are the symptoms?

Many subchorionic hemorrhages cause no symptoms and are found on a routine scan. When there are symptoms, the main one is vaginal bleeding. Belly pain is usually mild or absent.

Early signs

  • Vaginal bleeding or spotting, often brownish old blood, sometimes bright red
  • Frequently no symptoms at all, with the hematoma seen by chance on ultrasound
  • Mild cramping in some people, though pain is usually minimal
  • Bleeding that can come and go over days

Emergency signs — call 911

  • Heavy bleeding, soaking one to two pads an hour for two or more hours
  • Passing clots or tissue from the vagina
  • Severe or worsening belly cramping
  • Bleeding with fever or chills, which can signal infection
  • Feeling faint, dizzy, or lightheaded

Why it matters

Risks to you and baby

The strong chance it resolves

This is the most likely outcome, especially for a small hematoma. The body reabsorbs the blood over weeks and the pregnancy continues. Most people who have one go on to a healthy birth.

A modestly higher miscarriage risk

Overall, a subchorionic hemorrhage raises the miscarriage rate somewhat, roughly 14% versus 8% in one study. The risk is higher when the hematoma is large, found very early, or bleeding is heavy, and much lower for small ones.

Later pregnancy complications

A larger or persistent hematoma is linked to a modestly higher chance of later complications, such as preterm birth or the water breaking early, part of why your provider may keep a closer eye on things.

The worry itself

Bleeding in early pregnancy, and being told there is blood on the scan, is stressful. The uncertainty while you wait for a follow-up scan is hard, and it is reasonable to lean on support.

How it's found

How is it diagnosed?

It is diagnosed and followed with ultrasound. The scan confirms what it is, measures its size relative to the sac, and checks the pregnancy is healthy.

Transvaginal or abdominal ultrasound

Shows the crescent-shaped pocket of blood between the chorion and the uterine wall, confirms the pregnancy is in the uterus, and looks for a heartbeat.

Sizing the hematoma

The hematoma is graded by how much of the space around the sac it takes up. Larger ones, especially those taking up a quarter or more, carry a somewhat higher risk.

Follow-up ultrasound

A repeat scan checks whether the hematoma is shrinking, staying the same, or growing, and confirms the pregnancy is developing.

At the time of bleeding, or incidentally on a routine early scan. Follow-up scans are timed to the size and symptoms.

Treatment

How is it managed?

No treatment dissolves it; the body reabsorbs it. Care is watchful waiting: confirming the pregnancy is healthy, following the size, and knowing the warning signs.

Treatment paths

Management is expectant. For a stable pregnancy with a stable hematoma and no heavy bleeding, the plan is observation with a follow-up ultrasound. Providers often advise pelvic rest, avoiding sex and tampons while you bleed, and sometimes easing off strenuous activity or heavy lifting, though the evidence that these change the outcome is limited.

Monitoring

A repeat ultrasound confirms the hematoma is resolving and the pregnancy is growing. Larger or persistent ones may prompt closer monitoring later in pregnancy.

Can it recur?

It is generally a one-time event of this pregnancy rather than a condition that predictably recurs, and there is no established recurrence rate. Most resolve, and most people go on to a healthy birth. If you are Rh negative and bleeding, you may need a RhoGAM injection to protect a future pregnancy.

What you can do

Can it be prevented?

  • There is no proven prevention

    Nothing you do causes a subchorionic hemorrhage, and there is no established way to prevent one. No activity, diet, or supplement changes it.

  • Follow the size with your provider

    The most useful step is confirming the pregnancy is healthy and following the hematoma with ultrasound, so any change is caught early.

  • Know the red flags

    Heavy bleeding, passing clots or tissue, severe cramping, or feeling faint are the signs to be seen urgently. Knowing them is more valuable than any restriction.

  • Get RhoGAM if you are Rh negative

    If you are Rh negative and bleeding, a Rho(D) immunoglobulin injection protects future pregnancies from Rh problems.

Who is more at risk

Risk factors

It can happen to anyone
A subchorionic hemorrhage can occur in any early pregnancy, often with no identifiable reason.
Fertility treatment
Subchorionic hemorrhages are considerably more common after IVF and similar treatments, seen in a large share of those pregnancies in some studies.
A history of recurrent loss
People with a history of recurrent pregnancy loss are more likely to have a subchorionic hemorrhage.
A uterine difference
A difference in the shape of the uterus, such as a septum, is associated with a higher chance of one forming.

Do not wait

When to call your provider or 911

  • Call your provider for any bleeding, even light or brownish spotting, so it can be checked.
  • Seek urgent care for heavy bleeding, soaking one to two pads an hour for two or more hours, or for passing clots or tissue.
  • Go in for severe or worsening cramping, or if you feel faint, dizzy, or lightheaded.
  • Seek care for bleeding with fever or chills, which can signal an infection.
  • Ask about a follow-up scan to confirm the hematoma is resolving and the pregnancy is growing.

Talking to your team

Questions to ask your provider

  • How large is the hematoma relative to the pregnancy sac?
  • Has a heartbeat been seen, and how does that affect my odds?
  • When should I have a follow-up ultrasound?
  • Should I avoid sex, exercise, or heavy lifting, and for how long?
  • What bleeding or pain should send me in right away?
  • If I am Rh negative, do I need a RhoGAM shot?

Keep reading

More on subchorionic hemorrhage

All pregnancy guides articles

Good to Know

Subchorionic hemorrhage FAQs

Common questions about subchorionic hemorrhage, answered.

Will a subchorionic hemorrhage cause a miscarriage?

Usually not, especially if it is small. There is a modestly higher miscarriage risk overall, greater when the hematoma is large or found very early, but most resolve as the body reabsorbs the blood, and most people go on to a healthy birth.

Why am I bleeding brown blood?

The bleeding is often old blood draining from the pocket, brownish rather than bright red, and it can stop and start over days. Any bleeding should be checked, but brown old blood is common here and not a sign of fresh heavy bleeding.

Does the size matter?

Yes. A larger hematoma carries a higher risk than a small one, which is why your provider measures it. A small subchorionic hemorrhage has a very good outlook.

Is there any treatment?

There is no medicine that dissolves it; the body reabsorbs the blood on its own. Care is watchful: confirming the pregnancy is healthy, following the size, and watching for warning signs. Progesterone and blood thinners are not a general treatment.

Should I be on bed rest?

Strict bed rest is not proven to help. Providers often suggest pelvic rest, avoiding sex and tampons while you bleed, and sometimes easing off strenuous activity or heavy lifting, though evidence that these change the outcome is limited.

Can I exercise or have sex?

While you are actively bleeding, most providers advise avoiding sex and easing off strenuous exercise and heavy lifting, as a precaution. Once bleeding settles and a follow-up scan is reassuring, normal activity is usually fine.

Will it come back?

It is generally a one-time event of the current pregnancy rather than something that predictably recurs, and there is no established recurrence rate. If you conceived through IVF or have had recurrent losses, you are somewhat more likely to have one.

When should I go to the emergency room?

For heavy bleeding, soaking one to two pads an hour for two or more hours, for passing clots or tissue, for severe cramping, for bleeding with fever or chills, or if you feel faint or dizzy. These warrant urgent evaluation.

Medically Reviewed · Updated

Reviewed by Dr. Grace Lin, MD, FACOG · OB-GYN

Obstetrician-gynecologist focused on reproductive and sexual health for women: pregnancy, BV, yeast, trichomoniasis and HPV/cervical screening. Our editorial guidelines →

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