Document Type : Original Article
Authors
1
obstetric and gynecology, aswan faculty of medicine
2
aswan faculty of medicine, aswan university
3
Sohag faculty of medicine, Sohag university
Abstract
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 2 weeks 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 an 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 radiologist should be aware of this sceptical finding when providing counselling to patients and their families.
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