Subchorionic hematoma is a common cause of vaginal bleeding in early pregnancy, closely related to adverse outcomes such as miscarriage and premature birth. Its onset involves multiple factors such as coagulation abnormalities, immune imbalance, and placental vascular rupture. Western medicine mainly relies on progesterone supplementation and anticoagulant therapy, while traditional Chinese medicine improves the maternal and fetal environment through overall adjustments such as tonifying the kidneys, promoting blood circulation, and stabilizing the fetus. The combination of the two has synergistic advantages in regulating immunity, improving coagulation, and increasing the success rate of fetal preservation. However, existing research has problems such as a lack of standardization in syndrome differentiation and insufficient evidence of long-term efficacy, and there is an urgent need to integrate clinical evidence to optimize diagnosis and treatment strategies. This article provides a systematic review of the etiology, mechanism, and treatment progress of SCH in both traditional Chinese and Western medicine. It emphasizes the potential of combining traditional Chinese and Western medicine to reduce hematoma and improve pregnancy outcomes through the synergistic use of compounds such as progesterone, low molecular weight heparin, and Shou Tai Wan. The purpose of writing this review is to sort out controversies, propose the need for future multi-center large sample studies, establish a biomarker-based syndrome differentiation system, and develop targeted anticoagulant and immunomodulatory Chinese and Western compound preparations. Through interdisciplinary collaboration and technological innovation, we aim to promote the standardized and precise development of SCH diagnosis and treatment, ultimately improving the health level of mothers and infants.
Dun J, Tian L, Wang F, et al., 2021, Effects of Gushen Antai Formula Combined with Progesterone Injection on Clinical Efficacy, Symptoms and Signs, and Hormone Levels in Patients with Early Threatened Abortion. Med J Chin PLA, 33(7): 110–113.
Şükür Y, Göç G, Köse O, et al., 2014, The Effects of Subchorionic Hematoma on Pregnancy Outcome in Patients with Threatened Abortion. J Turk Ger Gynecol Assoc, 15(4): 239–242.
Ben-Haroush A, Yogev Y, Mashiach R, et al., 2003, Pregnancy Outcome of Threatened Abortion with Subchorionic Hematoma: Possible Benefit of Bed-Rest? Isr Med Assoc J, 5(6): 422–424.
Bondick C, Das J, Fertel H, 2023, Subchorionic Hemorrhage. StatPearls, Florida.
Yu G, Fan J, Yu Q, et al., 2023, Analysis of Influencing Factors of Subchorionic Hematoma after IVF-ET Pregnancy. Chin J Fam Plann, 31(12): 2962–2966.
Pan S, Lan Y, Zhou Y, et al., 2023, Associations Between the Size and Duration of Asymptomatic Subchorionic Hematoma and Pregnancy Outcomes in Women with Singleton Pregnancies. BMC Pregnancy Childbirth, 23(1): 555.
Lun W, Wang P, Xu T, 2023, Relationship Between Coagulation Status, Autoantibodies, Conception Methods and Subchorionic Hematoma. Chin J Obstet Gynecol, 58(11): 833–837.
Chen J, Deng X, Yao Z, 2022, Efficacy of Dydrogesterone Tablets in Threatened Abortion Due to Luteal Phase Insufficiency. Chin J Fam Plann, 30(12): 2807–2811.
Fang F, Chen X, 2024, Clinical Study of Low Molecular Weight Heparin Calcium Combined with Modified Shoutai Pill in Early Threatened Abortion with Subchorionic Hematoma. Shanghai Med J, 45(9): 29–32 + 36.
Fang F, Hu L, Chen X, et al., 2016, Clinical Study of Modified Shoutai Pill Combined with Dydrogesterone in Early Threatened Abortion with Subchorionic Hematoma. Lishizhen Med Mater Med Res, 27(4): 893–894.
Wang S, Wang Y, Chen X, 2022, Therapeutic Effect of Bushen Huoxue Antai Formula on Subchorionic Hematoma in Early Pregnancy. Shaanxi J Tradit Chin Med, 43(10): 1369–1372.
Wang S, Zhu L, 2019, Clinical Experience of Lingnan Luo’s Gynecology in Treating Threatened Abortion with Subchorionic Hematoma. Mod J Tradit Chin Med Clin, 26(1): 62–65.
Ma H, Li K, 2014, Li Keqin’s Experience in Treating Threatened Abortion with Subchorionic Hematoma. World J Integr Tradit West Med, 9(6): 589–591.
Xie B, Gao J, Luo S, 2022, Simultaneous Removal of Blood Stasis and Fetal Protection: A Review of TCM Diagnosis and Treatment for Prethrombotic State with Subchorionic Hematoma During Pregnancy. Chin J Tradit Chin Med Pharm, 37(11): 6218–6222.
Chao Y, 2006, Zhu Bing Yuan Hou Lun (Treatise on the Origins and Manifestations of Diseases): New Revised Edition. People’s Military Medical Press, Beijing.
Chen Y, Zhou X, 2019, Clinical Experience of TCM in Treating Subchorionic Hematoma During Pregnancy. Chin J Tradit Chin Med Pharm, 34(11): 5190–5192.
Tang R, 1977, Xue Zheng Lun (Treatise on Blood Syndromes). Shanghai People’s Publishing House, Shanghai.
Wang Q, 1976, Yilin Gaicuo (Corrections of Errors in Medical Classics). People’s Medical Publishing House, Beijing.
Wei G, Hu X, Chen Y, et al., 2024, Preliminary Discussion on the Objectification of Blood Stasis Constitution. Chin J Tradit Chin Med Pharm, 39(6): 2792–2795.
Chen Z, 1956, Jiao Zhu Fu Ren Liang Fang (Revised and Annotated Good Formulas for Women). Shanghai Health Publishing House, Shanghai.
Zhu Z, 2007, Ge Zhi Yu Lun (Supplementary Discourses on the Inquiring into Properties of Things). People’s Medical Publishing House, Beijing.
Fang F, 2018, Clinical Investigation on TCM Syndrome Distribution of Early Threatened Abortion with Subchorionic Hematoma. Mod Diagn Treat, 29(21): 3413–3414.
Li J, Zhao Y, Luo S, 2015, Research Progress on Pharmacological Effects of Shoutai Pill. New Chin Med, 47(5): 282–284.
Sun L, 2022, Effects of Self-Designed Yiqi Yanghu Hutai Formula Combined with Progesterone Injection on Patients with Early Threatened Abortion and Subchorionic Hematoma of Qi-Blood Deficiency Syndrome and β-HCG Levels. J Sichuan Tradit Chin Med, 40(9): 151–154.
Yang S, Wang W, Hu H, 2023, Modified Huanglian Ejiao Decoction for 35 Cases of Threatened Abortion With Subchorionic Hematoma Due to Blood-Heat Syndrome. Zhejiang J Tradit Chin Med, 58(6): 450–451.
Xu T, Lun W, Wang P, et al., 2024, Risk Factors and Pregnancy Outcomes of Subchorionic Hematoma in Patients With Threatened Abortion. Chin Med Eng, 32(1): 85–88.
Hoogen L, Roon J, Radstake T, et al., 2016, Delineating the Deranged Immune System in the Antiphospholipid Syndrome. Autoimmun Rev, 15(1): 50–60.
Li S, 2019, Analysis of the Relationship Between Serum Homocysteine and Anticardiolipin Antibody Levels With Recurrent Abortion. Jilin Med J, 40(6): 1253–1254.
Asato K, Mekaru K, Heshiki C, et al., 2014, Subchorionic Hematoma Occurs More Frequently in In Vitro Fertilization Pregnancy. Eur J Obstet Gynecol Reprod Biol, 181: 41–44.
Yue M, Ma L, Cao Y, et al., 2021, Application of a Nomogram for Predicting the Risk of Subchorionic Hematoma in Early Pregnancy With In Vitro Fertilization–Embryo Transfer/Frozen Embryo Transfer. Front Endocrinol (Lausanne), 12: 631097.
Wang X, Jiao J, Ma X, et al., 2023, Analysis of High-Risk Factors for Preterm Birth and Abortion in Subchorionic Hematoma. Chin J Pract Gynecol Obstet, 39(12): 1237–1240.
Pan J, Fang Y, Yan H, et al., 2022, Effects of Zishen Yutai Pill Combined With Dydrogesterone on HCG Levels and Hemorrhage Area in Threatened Abortion Patients With Subchorionic Hematoma. J Hubei Univ Chin Med, 24(5): 77–79.
Yang B, Zhou H, 2019, Clinical Observation of Modified Shoutai Pill Combined With Progesterone and Low Molecular Weight Heparin in Recurrent Abortion. World Chin Med, 14(6): 1502–1506.
Sun Y, 2023, Clinical Efficacy of Tranexamic Acid Combined With Dydrogesterone in Early Threatened Abortion With Subchorionic Hematoma. J Pract Gynecol Endocrinol Electron, 10(1): 36–38.
Zhang K, Huang Y, Wang S, 2022, Research Progress on Subchorionic Hematoma in Early Pregnancy. Zhejiang J Integr Tradit West Med, 32(10): 979–982.
Wang Z, Xiao J, 2020, Efficacy Analysis of Low Molecular Weight Heparin in Subchorionic Hematoma. Heilongjiang J Tradit Chin Med, 49(6): 424–425.
Cui L, 2023, Effects of Immunoglobulin Combined With Low Molecular Weight Heparin on Efficacy and Pregnancy Outcomes in Subchorionic Hematoma Patients. J Basic Med Forum, 27(29): 57–59.
Qian J, 2019, Effects of Immunoglobulin Combined With Low Molecular Weight Heparin on Therapeutic Outcomes, Pregnancy Results, and INF-γ/IL-10 Levels in Subchorionic Hematoma Patients. Matern Child Health Care China, 34(4): 749–752.
Xu D, Sun Y, Hu X, 2023, Clinical Observation of Modified Jiaoai Decoction in 72 Cases of Subchorionic Hematoma During Early Pregnancy With Cold Coagulation and Blood Stasis Syndrome. Chin J Tradit Med Sci Technol, 30(3): 545–547.
Wang Z, Liu Y, Deng C, 2021, Efficacy of Integrated Traditional Chinese and Western Medicine in Threatened Abortion With Subchorionic Hematoma of Liver Depression and Spleen–Kidney Deficiency Syndrome During Early Pregnancy. Chin J Fam Plann, 29(5): 917–920.
Li Y, Dong M, Chen CH, 2022, Effects of Modified Shoutai Pill Combined With Phloroglucinol Injection on Threatened Abortion With Subchorionic Hematoma. Hebei J Tradit Chin Med, 44(11): 1857–1860 + 1878.
Li Y, Wang Y, Liu Y, et al., 2022, Clinical Observation of Shoutai Pill Combined With Dydrogesterone in Subchorionic Hematoma During Early Pregnancy. Guangming J Chin Med, 37(7): 1264–1267.
Wu J, Ning Y, Liao J, et al., 2019, Effects of Auricular Acupuncture Combined With Dydrogesterone on Immune Factors and Serum CA125 in Early Threatened Abortion With Subchorionic Hematoma. Chin Acupunct Moxibust, 39(10): 1046–1050.