History: 21 yo female at 14 weeks 5 days gestation with vaginal bleeding
Solution: The diagnosis here is a threatened abortion based upon the clinical findings and the presence of a living fetus. The US demonstrates a subchorionic bleed of relatively low volume. The volume of the hematoma associated with the hemorrhage has been shown in a couple of studies to have an impact on the prognosis for the pregnancy. It is important to realize that this does not represent placental abruption since that is defined as placental separation after 20 weeks of gestation and that has very different implications for the pregnancy, i.e. it is considered an emergency. This pregnancy will still more than likely progress to term, although there is about a 1 in 2-5 chance (depending on the study) that the pregnancy will either terminate, or result in a premature birth.