A subchorionic hematoma (SCH) is a blood collection that forms between the uterine wall and the outer membrane of the gestational sac (the chorion). This pooling occurs when the chorion partially detaches from the lining of the uterus, often presenting as vaginal bleeding in the first half of pregnancy. Managing potential irritants is a primary focus of care to prevent the hematoma from growing or causing new bleeding. The goal is to support the body’s natural process of reabsorbing the blood clot or allowing it to be safely expelled.
Activities That Increase Intra-Abdominal Pressure
Physical actions that significantly engage the core musculature place stress on the uterus and the hematoma site. This strain increases internal abdominal pressure, which can mechanically irritate the blood collection. The sudden surge in pressure may cause the hematoma to shear further from the uterine wall, potentially triggering a fresh bleeding episode.
Lifting heavy objects is a primary concern; most healthcare providers recommend avoiding anything over 10 to 15 pounds. This restriction applies to daily tasks like carrying groceries, moving furniture, or lifting older children. Strenuous exercise, particularly high-impact activities like running, jumping, or intense core work, should be temporarily suspended.
Even involuntary actions, such as severe coughing or forceful sneezing, can momentarily spike abdominal pressure. When experiencing a cold or allergies, bracing the abdomen or leaning forward during these actions minimizes the sudden internal pressure surge.
The Role of Pelvic Activity and Strain
Activities that affect the pelvic region require careful management, as they can induce uterine contractions or increase blood flow. Sexual intercourse involves mechanical agitation and can lead to an orgasm, which causes the uterus to contract rhythmically. These contractions can disrupt the fragile blood clot, leading to new bleeding or expanding the hematoma.
Pelvic rest, including abstaining from sexual activity and avoiding vaginal insertion, is commonly advised until the hematoma resolves. Prolonged periods of standing or walking can increase pelvic congestion (the accumulation of blood in the pelvic veins). This increased vascular pressure may irritate the SCH or slow the natural healing process.
Straining during a bowel movement is another type of pelvic pressure that can aggravate an SCH. Constipation forces the abdominal and pelvic muscles to contract forcefully, mimicking heavy lifting. To avoid this, maintaining soft stools is highly recommended through increased fiber intake, adequate hydration, and mild stool softeners.
Medications and Supplements Affecting Clotting
Medications and dietary supplements can chemically interfere with the body’s natural clotting cascade, posing an internal risk to an SCH. Over-the-counter pain relievers known as non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen, inhibit platelet function, prolonging bleeding time. Aspirin, even in low doses, is a common blood-thinning agent that may increase the risk of active bleeding.
Several herbal supplements also possess anticoagulant properties that hinder stable clot formation. High doses of supplements like Ginkgo Biloba, garlic, ginger, and certain forms of Vitamin E may affect platelet aggregation. Using these substances can make the hematoma more prone to re-bleeding. It is imperative to consult a healthcare professional before discontinuing or starting any medication or supplement.
Monitoring Symptoms of Irritation
Monitoring the characteristics of vaginal discharge or bleeding is important for assessing the hematoma’s status. Bright red bleeding indicates fresh blood, suggesting an active or new bleed, often a sign of recent irritation or expansion. Conversely, dark red, brown, or black discharge signifies older blood being slowly expelled, typically indicating the hematoma is stable and resolving.
Spotting (light bleeding requiring only a panty liner) is less concerning than a heavy flow. Heavy bleeding is defined as soaking a standard sanitary pad completely in an hour for two or more consecutive hours. Cramping or uterine pain, especially with active bleeding, can signal that the uterus is contracting or that the hematoma is rapidly expanding. Any instance of heavy bleeding, severe cramping, or passing large clots requires immediate medical consultation.