Subchorionic haemorrhage

Subchorionic haemorrhage (SCH) occurs when there is perigestational haemorrhage and blood collects between the uterine wall and the chorionic membrane in pregnancy. It is a frequent cause of first and second trimester bleeding.

It typically occurs within the first 20 weeks of gestation. When seen in the first 10-14 days of gestation, they are also termed implantational bleeds.

  • crescentic collection with elevation of the chorionic membrane
  • depending on the time elapsed since bleeding, the collection will have variable echotexture
    • acute: hyperechoic and may be difficult to differentiate from the adjacent chorion
    • subacute-chronic: decreasing echogenicity with time
  • in almost all cases there is an extension of the haematoma towards the margin of the placenta 3

In early pregnancy, a subchorionic haemorrhage is considered small if it is <20% of the size of the sac, and large if it is >50-66% 5.

Fetal outcome is dependent on the size of the haematoma, maternal age, and gestational age 2. In most cases, the haematoma gradually decreases in size on follow-up. A subchorionic haemorrhage places the gestation at increased risk of:

If the collection extends up to the internal os and/or there is dilatation of the internal cervical os, this is an indication of extremely poor prognosis, almost always leads to impending miscarriage

General imaging differential considerations include:

Ultrasound - obstetric
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Article information

rID: 13250
System: Obstetrics
Section: Pathology
Synonyms or Alternate Spellings:
  • Subchorionic hemorrhage
  • Subchorionic haematoma
  • Subchorionic hematoma
  • Sub-chorionic haemorrhage (SCH)
  • Subchorionic haemorrhage (SCH)
  • Subchorionic haemorrhage
  • Sub-chorionic hemorrhage (SCH)

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