One in three pregnant women has a blood loss at some time during pregnancy, especially in the first quarter. They can be caused by a minor problem or be a symptom that something is not going well, but always, as usual, they are a matter of great concern in pregnant women. One of the most common causes of bleeding, especially during the first months of pregnancy, are intrauterine hematomas in pregnancy.
What are intrauterine hematomas
Intrauterine hematomas are known as interdeciduotrophoblastic hematomas. They appear when small lakes of blood are produced inside the endometrial cavity, between the most superficial layer of the uterus and the pregnancy tissue.
It is quite common in the first stage of pregnancy, however its cause is unknown. It is not usually accompanied by abdominal pain and the bleeding can be variable (even bleeding may not occur). In any case, always before a loss of blood in pregnancy you must immediately go to the doctor to assess the cause.
In Babies and more Blood loss in pregnancy: what is due in each trimesterIn general, intrauterine hematomas they do not usually cause pregnancy loss, especially when heartbeat is observed. In most cases, resting 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.
Before a hematoma, as a precautionary measure, pregnancy is considered high risk and intensive control is carried out to assess its evolution.
What happens if I have an intrauterine hematoma in pregnancy
Intrauterine hematomas are wedge-shaped or crescent-shaped between the chorionic tissue (of the placenta) 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 on the control ultrasound. The volume of the hematoma is measured using the formula of length (mm) x width (mm), which yields the size of the hematoma inside the uterus.
The prognosis of intrauterine hematoma is assessed taking into account two main elements:The location and size.
A small or moderate hematoma without the company of other symptoms has a good prognosis and is not usually a threat of abortion. As the pregnancy progresses the circulation normalizes and most of the bruises gradually disappear.
However, if there is heavy bleeding accompanied by abdominal pain, the doctor will assess the threat of abortion and 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 is located in a compromised site, it may be related to complications in pregnancy such as a placental abruption or premature rupture of the bag, which can lead to abortion or premature delivery in more advanced gestations.
In Babies and more How to prevent the risk of preterm birthTypes of bruises in pregnancy
Depending on where the hematoma is located, they can be classified into:
Subcorionic 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: is the least frequent type. The accumulation of blood does not affect the insertion of the placenta.
Many women suffer blood losses in pregnancy. As we said before, they are always a matter of consultation. If the doctor detects a intrauterine hematoma It is important to follow their indications, which will surely be absolute rest, prohibited sexual intercourse and in some cases, progesterone.
