What is the term for a low-pressure bleed from implantation with hypoechoic fluid between the uterine wall and the gestational sac?

• A. Subchorionic hemorrhage
• B. Placental abruption
• C. Corpus luteum hematoma
• D. Ectopic hematoma

Answer: (A)

A subchorionic hemorrhage is a small bleed at the site of implantation that collects between the uterine wall and the developing gestational sac. This occurs when a tiny portion of the chorion separates from the decidua basalis, creating a low-pressure collection that appears as a hypoechoic or anechoic area surrounding part of the sac on ultrasound. In early pregnancy, this is a common finding and the blood is typically contained by the surrounding membranes, so the pressure is low and the hemorrhage can resolve as the pregnancy progresses. Clinically, it can be associated with light vaginal spotting, but many resolves without complications; prognosis depends on the size and location of the bleed.

Placental abruption involves separation of the placenta later in pregnancy and presents differently, with possible painful bleeding and a retroplacental hematoma on imaging. A corpus luteum hematoma forms in the ovary as a hemorrhagic cyst, not between the uterine wall and the gestational sac. An ectopic hematoma is not a standard descriptor for intrauterine pregnancy findings and would relate to bleeding outside the uterus.