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Pre placental hemetoma
Am 32 years old and currently 26 weeks pregnant. I have been having intermittent brown discharge since 15 weeks, managed with Duphaston and progesterone suppositories. Despite a normal ultrasound back then, the spotting recurred every 10 days starting at 20 weeks (clearing within a day), so I was started on weekly progesterone injections. My 22-week anomaly scan was completely normal with no internal bleeding reported.
However, on August 31 (at 25 weeks), after an episode of vomiting, I experienced moderate brown bleeding (more than light spotting). I was hospitalized, and a scan revealed a preplacental hematoma (4.5 cm length × 1 cm depth) with a closed cervix. I received 4 doses of Dexamethasone and was discharged after 3 days.
I am feeling very anxious aCould the recurrent spotting I've had since 15 weeks have been caused by this hematoma? If so, why was it not visible on earlier ultrasounds, including the 22-week anomay.does this hemetoma increase the size any prrterm chance?
Answers (2)
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A pre-placental hematoma can sometimes go undetected on an earlier scan if it was smaller then or in a different position, so a normal 22 week scan doesn't rule one out later on.
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Please discuss the full scan series and your bleeding pattern with your obstetrician, who can judge if you need closer preterm monitoring.
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A closed cervix is reassuring, but any fresh bleeding or cramping should be reported to your doctor right away.
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Dr. Aastha Jain
Gynecologist
6 yrs exp
Ajmer
Yes, the earlier spotting was likely related to the same fragile placental vessels, though the visible collection itself may only have pooled recently.
* Why it was missed earlier: Fresh blood matches placental tissue density on ultrasound (isoechoic), making it invisible. Blood that drained out as brown spotting left behind no measurable pool to detect.
* Why it appeared now: Forceful vomiting likely increased abdominal pressure, triggering a larger bleed that pooled into the visible 4.5 × 1 cm preplacental collection.
* Reassuring signs: Your cervix remains closed, and the dexamethasone course provides lung protection for the baby. Continue pelvic rest and follow up with serial ultrasound monitoring.
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Disclaimer : The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding your medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.