A bump inside the bump: a case report of a chorionic bump

Fang, Yunjing; Nayyar, Roshini; Anpalagan, Anbu; Bonura, Priscilla; Ryder, Lynette

doi:10.1002/sono.12168

Cited by 4 publications

(6 citation statements)

References 8 publications

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“…However, the majority of cases involving CB disappear in the second trimester, which is consistent with the findings of earlier researches [1,2,3,4] , and raises the notion that the body can reabsorb the underlying hematoma. Fang, Yunjing, et al's findings differ from those of Hisham M. et al, who reported CB in the third trimester that continues to report a CB until delivery [11,12] .…”

Section: Discussionmentioning

confidence: 61%

The Prevalence and the Clinical Significance of the Chorionic Bump in Upper Egypt

Taha,

Abdulwahab,

Fahmy

et al. 2023

Evidence Based Women's Health Journal

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Objective:The purpose of this study is to provide some insight on our practical contact of the chorionic bump in upper Egypt, including its prevalence, subsequent prenatal course, and pregnancy outcome. Patients and Methods: All referred pregnant ladies to our specialized feto-maternal clinic at at Sohag, Aswan and Asuit governorate were offered ultrasound in early pregnancy to confirm pregnancy, diagnosis of PUL, determination of viability, suspected partial mole, and vaginal bleeding. The preceding LMP or conception date were used to estimate gestational age. all patients were asked for infertility treatment, previous obstetric history, coagulopathy or aspirin intake. Transvaginal ultrasound was done using Philips ClearVue 650. The appearance or lack of a chorionic bump was verified by two expert examiners differently. and documented for number of the CB, its position, appearance of yolk sac, fetal heart rate, then the size of the chorionic bump was measured in three dimensions and volume of the bump was calculated by this formula (length × width × height/2), 3D TVS was offered to all the patients follow up was done over next 2 weeks. the sonographic difference was compared. Results: Throughout span of a 4-year studies from June 2019 to December 2022, The incidence of chorionic bump in our study was 0.45%, with 12 patients diagnosed after examination of 2610 patients aged 19 -41 years old. Presentation of the cases were variable, with PUL (8.3%), determining viability (16.7%), and checking for suspected partial moles (25%) faced in most the cases. The identification of a chorionic bump made when a ultrasound revealed an irregular, convex protrusion from the choriodecidual surface into the first-trimester gestational sac (GS). The lesion's dimensions ranged from 0.05 to 10.8 cm3, and also its average diameter was around 0.6 and 3.4 cm. Twelve individuals were detected with chorionic bumps; nine (75%) had a single bump, three (25%) had two bumps, and in this latter group all pregnancies ended in demise (100%) as a consequence. 3 of the twelve patients with chorionic bump were wrongly diagnosed as partial moles. The size of CB and pregnancy outcome were not strongly linked. Overall, (8/12) (66.6%) showed live birth; one was Preterm delivery admitted to NICU then discharged. (33.3%) experienced fetal demise; three of them were aborted at the time of CB diagnosis. Interestingly, the time period required for the disappearance of CB varied, but most cases experienced disappearance during the next visit; over 2weeks suggesting absorption of the pathology i.e. hematoma. Finally, in none of the cases there were any possible long-term defects. Conclusion: Our research has revealed that the chorionic pump is uncommon finding that may have misdiagnosed during first trimester screening, almost always, it is slowly fading away over time. representing its pathology as a hematoma, and it doesn't considerably increase the likelihood of miscarriage in the first trimester unless it is multiple. Despite this, obstetricians and radi...

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Section: Discussionmentioning

confidence: 61%

The Prevalence and the Clinical Significance of the Chorionic Bump in Upper Egypt

Taha,

Abdulwahab,

Fahmy

et al. 2023

Evidence Based Women's Health Journal

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“…10 In that case, the CB evolved into a large cystic mass on the fetal surface of the placenta, which was diagnosed as a septal cyst. 10 However, the available documentation in that case suggests that the CB was indeed a subamniotic hematoma, thus supporting our observation that a large CB can progress to a subamniotic hematoma in the second trimester of gestation, usually without additional risks to the fetal wellbeing and outcome of the pregnancy. A true placental cyst, another differential diagnosis, is a rare condition that seems to be an intrinsic primary lesion of the placenta and, therefore, with no relationship to a CB.…”

Section: Discussionmentioning

confidence: 99%

“…Based on a review of the literature, only one report of a CB progressing to a subamniotic hematoma has been described previously. 10 In that case, the CB evolved into a large cystic mass on the fetal surface of the placenta, which was diagnosed as a septal cyst. 10 However, the available documentation in that case suggests that the CB was indeed a subamniotic hematoma, thus supporting our observation that a large CB can progress to a subamniotic hematoma in the second trimester of gestation, usually without additional risks to the fetal wellbeing and outcome of the pregnancy.…”

Section: Discussionmentioning

confidence: 99%

Chorionic bump: Progression to a subamniotic hematoma

Galleguillos

Sepúlveda²

2021

Ultrasound

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Introduction A chorionic bump is an increasingly recognized ultrasound finding in first-trimester scans, which has been associated with early pregnancy loss. In ongoing second-trimester pregnancies, however, chorionic bumps usually resolve over time with no deleterious effect on the fetus. In this report, we describe the incidental ultrasound detection of a chorionic bump in early pregnancy and its progression to a subamniotic hematoma in the second trimester of pregnancy that persisted as such until delivery. Case Report A round, echogenic mass protruding from the choriodecidual surface measuring 13 × 11 × 8 mm was first identified during a transvaginal scan at 6.3 weeks’ gestation. Subsequent follow-up scan at 8.3 weeks revealed an increase in the size of the chorionic bump to 25 × 20 × 19 mm, which remained stable as determined by the routine late first-trimester scan. At the second-trimester scan, a subamniotic hematoma was identified in the surface of the placenta, close to the insertion of the umbilical cord. Subsequently, the pregnancy proceeded uneventfully. Discussion The etiopathology and clinical significance of a chorionic bump remain unclear. The case herein reported demonstrates that a chorionic bump can grow considerably without having a deleterious effect on the early embryo and, occasionally, can persist throughout pregnancy as a subamniotic hematoma. Conclusion A chorionic bump can occasionally progress to a subamniotic hematoma from the second trimester onwards. This observation further supports the hypothesis that a chorionic bump is the result of choriodecidual bleeding. An alternative explanation for the development of subamniotic hematomas is proposed.

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“…This is true for the general population as well as for patients with a history of infertility treatment. A computerized search of the Pubmed/MEDLINE database using the term “chorionic bump” revealed six larger series describing between eight to 57 cases and eight isolated reports describing one or two cases. Our report adds an additional 23 cases, for a total of 190 cases reported in the English literature.…”

Section: Discussionmentioning

confidence: 99%

“…This led to the conclusion that this sonographic feature is associated with a guarded prognosis. 1 Until now, the vast majority of cases of chorionic bump have been detected in pregnancies presenting before 11 weeks' gestation, [1][2][3][4][5][6][7][8][9][10][11][12][13][14] with only one report including cases referred for nuchal translucency thickness measurements at 11 to 13 weeks' gestation. 9 However, the latter report was based on pregnancies with available cytogenetic studies, and neither specific clinical details nor pregnancy outcomes were reported.…”

Section: Introductionmentioning

confidence: 99%

Chorionic bump at 11 to 13 weeks' gestation: Prevalence and clinical significance

Sepúlveda¹

2019

Prenatal Diagnosis

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Objective To gather additional data on pregnancy outcome when a chorionic bump is detected at the time of the 11‐ to 13‐week scan. Methods The presence of a chorionic bump was prospectively recorded in a database of women presenting for their first‐trimester sonographic screening. Clinically relevant information was obtained by reviewing ultrasound reports and medical records or contacting the referring obstetrician or the parents themselves. Results During a 4.5‐year study period from June 2014 to December 2018, a chorionic bump was identified in 23 out of 3375 pregnancies, for a prevalence of 1/147 or 0.7%. All women were asymptomatic at the time of evaluation. The chorionic bump was single in 21 (91%) cases, located in the central part of the placenta in 17 (74%) cases, and the median largest diameter was 20 mm (range, 10‐43). Although the placenta was low‐lying in 14 (61%) cases, all but one patient had a normally located placenta at the midtrimester anatomy scan. With the exception of one pregnancy complicated with trisomy 21, the outcome was universally good. Conclusion Our experience suggests that a chorionic bump detected during the 11‐ to 13‐week scan is usually a transient, is incidental finding, and probably has no clinical significance.

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A bump inside the bump: a case report of a chorionic bump

Cited by 4 publications

References 8 publications

The Prevalence and the Clinical Significance of the Chorionic Bump in Upper Egypt

The Prevalence and the Clinical Significance of the Chorionic Bump in Upper Egypt

Chorionic bump: Progression to a subamniotic hematoma

Chorionic bump at 11 to 13 weeks' gestation: Prevalence and clinical significance

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