The chorionic bump in an ectopic pregnancy

Abstract

The chorionic bump, an irregular, convex bulge of the choriodecidual surface into the gestational sac (GS), is a recently described, uncommon abnormality of the 1st-trimester GS and is associated with a guarded prognosis for early pregnancy. The case of this 42-year-old female demonstrates a previously unreported relationship: a transvaginal sonographic finding of a chorionic bump associated with a spontaneous tubal ectopic pregnancy. This might support the hypothesis that the chorionic bump represents a small hematoma that bulges into the GS.

Clinical significance of first-trimester chorionic bumps: a matched case-control study

“…The exact etiology of a chorionic bump is unknown, but it is thought to be most likely a hematoma, as the echogenicity of the bump changes to become more echogenic over time and has the signal characteristics typical of hemorrhage on magnetic resonance imaging. Histological examination of the conceptus after spontaneous miscarriage also supports this hypothesis. A chorionic bump is an entity different from a subchorionic hematoma, which is the presence of echolucent fluid (blood) between the uterine wall and the chorion or within the endometrial cavity (Figure c).…”

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

“…After the late first‐trimester period, the possibility of fetal demise or pregnancy loss later on in pregnancy decreases dramatically, especially in fetuses with no abnormal findings on scan . The incidental reported association with ectopic pregnancy, fetal malformations such as acrania or forearm reduction defect, and chromosomal abnormalities were also absent from our series, although one of our fetuses had trisomy 21.…”

“…Several factors can explain this difference. First, previous studies were based on earlier pregnancies from a largely heterogenous population, which included a significant number of cases with an anembryonic sac, an embryo without detectable heartbeat, or even an ectopic pregnancy . Obviously, in this setting, the possibility for poor pregnancy outcome is very high.…”

The chorionic bump: Etiologic insights from two pathologic pregnancies

“…A subsequent case report of a chorionic bump in a tubal ectopic pregnancy was offered in support of this premise, considering the association of hemorrhage with ectopics. However, no pathologic correlate of the bump was identified . In a case of first‐trimester embryonic demise associated with multiple chorionic bumps, the authors concluded that findings of hemorrhage on histopathologic examination of the aborted tissue suggested that hematomas were the source of the bumps .…”