What is a Subchorionic Hematoma ?

What is a Subchorionic Hematoma?

“A subchorionic hemorrhage, also known as a subchorionic hematoma or simply SCH, is created when blood gathers in the space between the placenta and uterus. The technical term is chorion, but many doctors will simply call it a blood clot. These clots can be serious because they might grow large, and thus cause the placenta to separate from the uterine wall. This is especially true if the clot or bleeding becomes too large, cannot be reabsorbed by the body, or develops in a spot that makes separation more likely.”

These are two links with more clinical information about what a SCH is:  http://emedicine.medscape.com/article/404971-overview

http://www.newkidscenter.com/Subchorionic-Hemorrhage.html

I personally experienced a SCH in 2009 with my pregnancy. It all began on Thanksgiving Day 2009, I was in the kitchen and literally felt like I peed my pants. I looked down to see blood going down my legs. A day I will never forget.  Having suffered 4 other pregnancy losses I was terrified and felt I was miscarrying. I was 11-12 weeks at this time. I called my midwife ( I was going to have a homebirth)

When I went in to see her she did a ultrasound , I was prepared for the worst, but she found my little baby’s heart beat! She knew quickly it was hematoma. I had not heard of this before. She told me my body should just absorb the clot in the coming weeks and should be fine.

I resorted to much research online. Google world is VERY scary full of many OPINIONS.  I went on to bleed for months. From bright red down to a sticky brownish discharge.  Having 5 other children ‘bed rest’ was a joke. I wanted to blog about SCH so others could hear and read a real story not just clinical and scientific scares. I was 38-39 during this pregnancy so I do wonder if as I read age was a factor. I was also under much stress and my diet was not as good as my previous. Though when I ate I ate organic, juiced etc. I just did not consume enough protein etc.  If you read the links the clinical parts state miscarriage and preterm labor could occur. I also recently read that PROM can occur (which was what happened to me)

Here is my son’s birth story;

On April 7, 2009 during my home school meeting I had a gush of fluid…..I went to the midwife office and it was confirmed with a nitrizine strip that it was amniotic fluid. I was escorted to the hospital. The OB did the same test and it was negative so I went home. Much later that night I leaked again so I was informed I should go back to the hospital. I was having some contractions that night (april 8/9) I thought that the baby would come that night. I was even having bloody show. At one point I passed a huge old clot. The nurses were baffled (said I pooped)  It turned out it was the old subchorionic  hematoma clot   that had caused so much bleeding from November till February.

After I passed the clot things seemed to slow and then stopped. I feel my body went into this “labor” to pass the subchorionic hematoma clot.

I was also given two doses of steroids to “develop the baby’s lungs”.

By Saturday April 11 nothing was going on. After I spoke with the OB she told me “she could not make me stay and I could sign a AMA” Which is what I did. I went home that evening.

I went to Easter Mass with my family and had a wonderful Easter with my family, and received the Sacrament of Anoiting of the sick. My husband made sure I took it easy. Later that night I noticed more leaking….

On Monday April 13, I had an appt to have another US and to check amniotic fluid levels. The levels were lower and I was sent to another hospital  that did an Amni Sure test. I was told it was a more accurate test to see if I was leaking fluid. Of course it was positive. This hospital started admitting me but I did not want to be there. I said I would go back to the other hospital.  I left and proceeded to go to the other hospital. But first I made a lunch stop at our local health food store, I needed a juice. I prayed on the way for God to show me what to do. I just wanted to go home.

As I was standing in line at the juice bar I felt a huge gush of fluid! I was like oh boy this is it I am going ot deliver here at Native Sun! Because with my other births once my ‘water broke’ I delivered within 10 minutes! I got my lunch and left. I managed to drive myself back . Praying I would make it! Well I made it. Again nothing happened.

So I was in the hosptial again…I was told by the Ob I could not leave my room because my “baby could fall out”. SO I continued to stay in my room. I had US done twice a week to check on fluid levels and see how baby was doing. Everything was still going well. No signs of infection. I was on IV antibiotics then on oral for 14 days.

By the week of April 20 I was going nuts inside. I missed my family. I begged daily to just go outside. I was getting very depressed. I would open the window that barely opened and got a few minutes of sunshine each morning. I finally ‘got permission’ to attend Mass in the chapel on Wednesday/thursday. What a Blessing! I had the Eucharist brought to me most days.

On April 24 a sweet nurse took me outside in a wheel chair! Over the next couple of days my husband took me outside too. Freedom, fresh air, sunshine! On Monday April 27 my husband proceeded to take me out but this time the nurses at the nurse station yelled at us “you have strict orders you can not leave your room” my husband just said “she has been out for several days and I am taking her out again” .After we came back in the head nurse came in to tell me that they called my OB and she said “if I leave my room again she will discharge me as her patient” We said nothing. I was compliant as I could be so far. Sure I questioned everything. I am an educated mom! I have had three previous home births and my first two were natural births as well.

I had explained my feelings several times. How I trusted my body I would know if my baby was coming out. That my baby would not just fall out. Even though I was not ‘allowed’ out of my prison I still did yoga stretches daily and paced the floor. I could not just sit in bed. I told the Dr and nurses this as well.

On April 29 the Dr came in to tell me I was about to have a visit from many people. Well a total of 8 people entered my room. The head nurse sat down and began telling me that since I was not compliant about leaving my room (even though I had been compliant she stated) that if I left my room again or left AMA they would call child services on me because I was endangering the life of my unborn child. I was also told if they felt my baby was in danger of infection I would be forced to induce. I was shocked. I said nothing.

I cried all afternoon, which caused me to leak alot that afternoon and evening. I called some people I knew including another local doula that called her lawyers for input. I just wanted to leave. I trusted no one there. I was even told by someone that I brought it on myself. I did state and understood the rules and I know they have to protect themselves against lawsuits. But do patients have no rights?

The next day April 30 I had another US and the fluid levels were very low and the baby was acting as they liked. I explained how I had been threatened and very upset the day before. The perinatologist explained to me that he wanted me induced at 34 weeks that the ‘risk of infection goes up”

After much prayer  we decided we did not have a choice we would have to be induced. I just wanted out of there. Since I was informed I would NOT be allowed to leave until the baby was born. I could be there till June. The OB told me I was making my self miserable by not being induced.

I was finally allowed to leave my room and walk the halls only. Boy did I walk that weekend in hope I would go into labor on my on. I did not want to be induced. After much research and prayer we decided on cytotec even though it is not safe. I did not want pitocin because I would be confined to the bed on an IV. I had discussed my options with the OB she knew how I felt. She knew also I declined having a hep lock. I hate needles!

Well Monday May 4 was the day we were to be induced. However the Ob came in and told me she would not induce me until I got the hep lock and she stormed out of the room. I was furious! She knew the week before how I felt about this. I was trapped, forced to have something I refused. So I got the hep lock…and was induced at 10:30 am. Two hours later I was allowed up and walked the halls. I was on the fetal monitor for 15 minutes every hour. Nothing was happening.

At 3 pm another dose of cytotec was administered, into my cervix this time. I started having some cramps. I continued to walk the halls and had some cramping all afternoon and evening.

I started have some ‘bloody show’ by 10 pm. So I knew something must be happening. By midnight I began telling my husband”I do not think I can keep doing this all night” not a normal thing for me. Since I do not feel my contractions. I realized being induced sucks and no wonder so many moms get epidurals. I did not want one I was just concerned how long could I go thru this.

At 12:20 am the nurse checked me, I was only 3 cm…I thought oh my. All along I prayed and prayed. I was rocking in then chair I was so sick of the fetal monitor! I was sick of the hep lock that was burning in my arm. I felt pressure but in my head was like ‘no way it is my imagination’ I made as my hubby calls it ‘my sound’ and he was said to me ‘what are you doing?” He called the nurse in telling her I was making ‘my pushing sounds’. They had to lift me off the chair and into the bed, I could not move. Ryan sat me in the bed, removed the lovely mesh panties, and I leaned forward to push, Ryan said the baby’s head was crowning.

I remember all the team rushing in. I remember the Ob coming in, Ryan said she was half sleeping fumbling to get her gloves on. The OB told me to pant! I thought to my self “yea right, I am not pushing my body is expelling him!”

Sebastian Octavius FLEW out onto the bed with Ryan right there at 1:39 am. The Ob lifted him onto my tummy. So I got to hold him after all.I prayed over him over and over, thanking God for him and praying he was ok. He was so tiny compared to my other 5. Ryan cut the cord. After a few minutes with the NICU Dr he brought him back to me and said I could try to nurse him! He was a cool neonatologist!

I held him and tried to get him to nurse but he was not ready. At 2:30 am I was told he had to go to the NICU. I was sad, he was starting to show signs he was ready to nurse, he was licking and rooting.

Later I was told Sebastian’s blood sugar was low (I knew it would be since he did not get to nurse) so he needed an IV with glucose. (had told them already no formula, bottles or pacifiers). The NICU wanted to give him a bottle I again said no.

He had fluid in his lungs (because he was born so fast it was not naturally expelled) he needed some oxygen via a nasal canula. He also had elevated WBC so the started IV antibiotics. The blood cultures never did show a positive infection.

I was finally allowed to see him in the NICU at 4 am. I held him on my bare chest. The only time I was not allowed with him was during the shift changes. Those times were so hard. At 6:30 am we had to leave. I pumped a lot.I tried to sleep for a few minutes but knew I would not sleep till he was safe at home. I place a Rosary on his incubator.

I continued kangaroo care all day and night and pumped, I pumped every hour for 20/30 minutes. One of the NICU Dr’s was not as supportive about me nursing him and preferred I pump and give him the colostrum in a bottle! I explained how breastfeeding was easier for them than bottle feeding…

At one point Sebastian was rooting on me so I placed the nipple near his mouth and was trying to hand express a few drops. A particular nurse yelled at me saying are you nursing him? You are not suppose to nurse him. I told her I was not to look that my nipple was by his mouth.

On May 6 my favorite NICU Dr told me I could try to nurse him at 2 pm.Because he was doing so well. I was shocked and thrilled! IT was hard at first but after a couple of tries he latched on! I was crying and praying to Our Lady of La Leche! I was allowed to nurse him every three hours that day and night. I was still pumping every hour for about 30 minutes. the nurses thought I was pumping to much. I told them no this was how often I normally nursed my newborns.

Sebastian continued to shocked the NICU. He was doing great. HE was off the oxygen on May 7 and was allowed to room in with us that evening! He was on a bili blanket too because he was jaundiced, his bili count was 14 and rising. The nurses all told me it was rare a 34 week baby went home so fast. And that he was nursing!

I continued to pump since Sebastian was very sleepy. I spoke with one of the ‘good’ Lactation Consultants on staff and she reminded me of some options I could try. One being using a syringe to feed while I nursed at the same time. So Ryan would slowly administer my pumped breast milk in the tiny corner of his mouth while I nursed him.

On May 8 late in the afternoon we went home with Sebastian. But we had a nurse coming over to check his bili count and weigh him. The other children had not seen him yet so it was a an emotionally homecoming!

The nurse came out later that evening bringing the bili bed. With strict instructions that I had to have him on the bed 24/7 only allowed to nurse him every two hours for 30 minutes. I bit my tongue. I just shook my head in agreement…….

I continued to pump every hour no longer than three. Because I knew he was not nursing as well as she should. We also continued to administer the breastmilk in his mouth while he nursed, this kept him sucking.

I spent a lot of time in the beautiful sunshine. I tried to use the bili bed as instructed but I just could not allow him to cry.

On May 17 the bili bed left the house! IT was over Sebastian was having all breast milk poops, he had gained 10 oz and his bili count was normal!

 

 

Sebastian 5 years old with momma

Sebastian 4 years old at the Big Latch On