Preplasental and subchorionic massive hematoma in the third trimester: an overview of the definition of antenatal bleeding and hematomas; Case Report and Literature Review

Subchorionic hematoma occurs between myometrium and placental membrane and / or placental border; under the chorionic plaque. Pre- placental hemorrhage occurs between placenta and amniotic liquid/placental membranes; under the fetal membranes (amnion). Subchorionic and pre- placental hemorrhage have similar pathogenesis and clinical features. Massive subchorionic hematoma and pre- placental hematoma were seen at the same time in our 3th trimester case. The patient applied to our clinics for vaginal bleeding in 27th gestational week. On the third week follow-up, the patient was transfused 3 units erythrocytes suspension and 2 units fresh frozen plasma because of the hemoglobin level was 7 g/dl and the fibrinogen level was 200 mg/dl. Massive subchorionic hematoma in the third trimester had persisted more than 5 weeks without affecting the fetal perfusion. On fifth week follow-up, in the 32th week of pregnancy, the patient underwent cesarean section because of previous cesarean section, having contractions and cervical dilatation. Massive subchrorionic hematoma persists to the delivery time with giving a healthy newborn or with badly affected pregnancy. True anatomic diagnosis of the antepartum hemorrhage is important for correct approach.

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