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Chorionic hematoma is the pooling of blood between the chorion, a membrane surrounding the embryo, and the uterine wall. [2] It occurs in about 3.1% of all pregnancies , [ 2 ] it is the most common sonographic abnormality and the most common cause of first trimester bleeding .
Uterine atony is the most common cause of postpartum hemorrhage. [14] Trauma: Injury to the birth canal which includes the uterus, cervix, vagina and the perineum which can happen even if the delivery is monitored properly. The bleeding is substantial as all these organs become more vascular during pregnancy.
Causes of increased foetal-maternal haemorrhage are seen as a result of trauma, placental abruption or may be spontaneous with no cause found. Up to 30ml of foetal-maternal transfusion may take place with no significant signs or symptoms seen in either mother or foetus . [ 3 ]
Besides placenta previa and placental abruption, uterine rupture can occur, which is a very serious condition leading to internal or external bleeding. Bleeding from the fetus is rare, but may occur with two conditions called vasa previa and velamentous umbilical cord insertion where the fetal blood vessels lie near the placental insertion site unprotected by Wharton's jelly of the cord. [11]
Funic souffle (also known as funicular or fetal souffle), is a blowing sound heard in synch with fetal heart sounds, and may originate from the umbilical cord. It has also been described as a sharp, whistling sound that is synchronous with the pulse of the foetus, usually heard during the second trimester of pregnancy (13–28 weeks). [3]
Along with placenta previa and uterine rupture it is one of the most common causes of vaginal bleeding in the later part of pregnancy. [6] Placental abruption is the reason for about 15% of infant deaths around the time of birth. [2] The condition was described at least as early as 1664. [7]
Some potential causes of circumvallate placenta include reduced amniotic fluid pressure, circumferential hemorrhage, and superficial or deep implantation of the embryo within the uterine wall, although these potential causes are still not well-understood in terms of their relation to circumvallate placenta. [4]
Retroperitoneal bleeding is an accumulation of blood in the retroperitoneal space. Signs and symptoms may include abdominal or upper leg pain , hematuria , and shock . It can be caused by major trauma or by non-traumatic mechanisms.