Chorionic Bump: Radiologic Features and Pregnancy Outcomes

Cureus. 2020 Nov 14;12(11):e11480. doi: 10.7759/cureus.11480.

Abstract

Background Chorionic bump is a rare condition defined as a bulge or protrusion from the choriodecidual surface into the gestational sac. The limited literature on this infrequent entity suggests that the pregnancies with multiple chorionic bumps mostly result in fetal demise. Aims To review the available literature and the patients from our institute having sonographic findings of chorionic bump and making the sonographers and radiologists aware of this known cause of first-trimester pregnancy loss. Study design A retrospective review of the cases diagnosed at our institute during the last four years. Methods and materials Single-center institutional data for four years (January 2016-December 2019) was accessed using ICD codes. IRB approval was waived owing to the anonymized use of patient data. Results Six female patients diagnosed with chorionic bump were included, with a mean age of 29.83±12 years. The average gestational age at the time of diagnosis was 8.16±3 weeks. The most common sonographic findings were a protrusion from the chorionic wall into the gestational sac cavity, having a central hypoechoic region with peripheral hyperechoic rim (isoechoic to the chorion) and having no vascularity (n=5), and the less common finding was a hyperechoic protrusion with no vascularity (n=1). n=5 had a single lesion, and n=1 had two lesions. The average diameter of the lesion in the largest dimension was 18±11 mm. n=3 pregnancies resulted in a first-trimester miscarriage, and n=3 pregnancies delivered healthy babies at term. Conclusions A chorionic bump significantly increases the risk of a first-trimester miscarriage.

Keywords: abortion; chorionic bulge; first-trimester; miscarriage; transvaginal; ultrasound; vaginal bleeding.