Is a subchorionic hemorrhage risky at 8 weeks of pregnancy?

Hi doctor,

My wife, who is 23 years old, has autoantibodies SSA strong positive 3+, SSB borderline positive, and RO52 strong positive 3+. She lost her first pregnancy last year, because CHB was found in the fetus by TIFFA at 19 weeks with fetal hydrops and bradycardia. Now, she is eight weeks pregnant.

Our obstetrician planned the treatment as Aspirin 75 mg once daily, Enoxaparin 20 mg daily, Progesterone 200 mg tablet once daily, and Dailyfol. She also planned to start fluorinated steroids from the 12th week and immunoglobulin from the 16th week.

When we went for a second opinion two days back, the fetal medicine specialist found a large subchorionic hemorrhage and advised just to stop Enoxaparin. She advised us to come back again after a month, as it is a high-risk pregnancy. Why did she say so?

Later, we consulted our obstetrician, and she advised us to stop taking Enoxaparin temporarily because it is necessary for controlling antibodies. She advised Duphaston 10 mg twice daily, Xamic 500 mg twice daily in addition to the above, and asked us to have a review after three days.

We need a clear direction now, please answer our questions.

• Can we prevent CHB with the above medication?
• Is there really a need for Enoxaparin?
• Who is the right person to follow?
• Should she get steroids for the prevention of CHB?

She has morning sickness and back pain from the beginning of pregnancy.

Please advise.

Hi doctor,

Thank you for the reply.

Actually, last time, till the third month, my wife was very well. But in the third month, she used to faint when she stood for a minimum of 10 minutes. But, her gynecologist said there is nothing to worry.

Then, by the fourth month, as the doctor could not hear the fetus' heartbeat easily, she advised a TIFFA scan. This time, I consulted with a gynecologist, whom they recommended in my area. After the termination of pregnancy, my wife was on regular Aspirin 50 mg and Folinol.

Actually, I am worrying more this time, and so I always need a second opinion. Our gynecologist said Xamic 500 is to control bleeding. She also said that at present, there is no bleeding, and it happened once internally.

If so, then why did she prescribe Xamic? Also, the fetal medicine specialist did not prescribe anything. Why?

Please advise.