Transcervical chorionic villus sampling. After cleansing your vagina and cervix with an antiseptic, your health care provider will open your vagina with a speculum and insert a thin, hollow tube through your cervix. When the catheter reaches the placenta, gentle suction will be used to remove a small tissue sample.
Full Answer
What does a chorionic bump on the first-trimester sonogram mean?
Conclusions: The finding of a chorionic bump on the first-trimester sonogram is associated with a guarded prognosis for the early pregnancy (live birth rate <50%); it probably represents a small hematoma that bulges into the gestational sac, and, in our series, most patients had a history of infertility treatments. Adult
What is the chorionic “bump”?
We describe a series of patients with a previously unreported sonographic finding, the chorionic “bump,” which is an irregular, convex bulge from the choriodecidual surface into the first-trimester gestational sac.
What is the prognosis of a chorionic bump?
Treatment and prognosis. A chorionic bump has been associated with a guarded prognosis for early pregnancy where the rate of miscarriage has been considered twice the normal rate 2. Studies have suggested a 62-65% live birth rate (83% if no other abnormalities) 5,7, but some have suggested that the risk may be overestimated 7.
What is chorionic bump in pregnancy?
Chorionic bump is a rare pathology, often described as a convex polypoid bulge or an ovoid mass protruding from the chorion into the early gestational sac, sometimes seen at the first-trimester ultrasound evaluation. It is typically located within the thickest part of the developing placenta, chorion frondosum.
Can a chorionic bump go away?
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.
When do chorionic bumps go away?
A subset analysis was performed on pregnancies in which the gestational sac, yolk sac, and an embryo with a heartbeat were seen and found that in this group the live birth rate was 83% (34 of 41). Furthermore, in 91% of cases, the chorionic bump resolved by 12 weeks of gestation (31 of 34).
What causes chorionic bump?
The cause of CB remains unclear and several assumptions have been proposed as to whether it is the cause of early demise or follows it [2]. The chorionic bump might represent the following: a hematoma, an area of hemorrhage, a non-embryonic gestation, or a demise of an embryo in a twin pregnancy [2,5].
Does chorionic bump cause miscarriage?
The literature review suggests that chorionic bump is a cause of first-trimester pregnancy loss, and it doubles the miscarriage rate as compared to when there are no risk factors [3]. In this article, we present a series of six cases of the chorionic bump, which we diagnosed at our institute in the last four years.
What does chorionic mean?
Definition of chorionic 1 : of, relating to, or being part of the chorion chorionic villi. 2 : secreted or produced by chorionic or related tissue (as in the placenta or a choriocarcinoma)
Can Subchorionic hemorrhage cause birth defects?
Subchorionic bleeding does not usually cause any problems. However, scientific research is inconclusive on whether SCH can cause pregnancy complications , such as preterm delivery or pregnancy loss.
What is chorionic plate?
The chorionic plate is a layer of vascularized chorio- allantois (trophoblast and mesoderm) that comprises. the fetal side of the placental disc. As such, its inner. surface borders, or provides a roof for, the blood-filled.
What can I expect to see on a 7 week ultrasound?
The technician will measure the size of your gestational sac and also take a crown-to-rump measurement of the embryo, if it's visible. At 7 weeks, your baby should be about 5 to 9 millimeters (mm) in size and the gestational sac will be about 18 to 24 mm.
What can I expect to see on a 6 week ultrasound?
At this stage of your pregnancy, a yolk sac should be visible inside the gestational sac. It tends to look like a tiny balloon, and your doctor wants to see its size and shape, which are indicators of your pregnancy health.
Why is CVS test performed?
Chorionic villus sampling, or CVS testing, is done during pregnancy to find out if your baby has certain genetic problems. You do not have to get CVS testing. If you choose to do so, you'll undergo it when you're around 10 to 13 weeks pregnant. The test is safe, causes minimal discomfort and is very accurate.
Does para include current pregnancy?
Gravidity (gravida) is the number of times a patient has been pregnant. This includes a current pregnancy. Parity (para) is the number of times a patient has given birth to a viable child.
When is molar pregnancy detected?
An ultrasound of a complete molar pregnancy — which can be detected as early as eight or nine weeks of pregnancy — may show: No embryo or fetus. No amniotic fluid. A thick cystic placenta nearly filling the uterus.
What is a chorionic bump?
The chorionic bump: a first-trimester pregnancy sonographic finding associated with a guarded prognosis. The finding of a chorionic bump on the first-trimester sonogram is associated with a guarded prognosis for the early pregnancy (live birth rate <50%); it probably represents a small hematoma that bulges into the gestational sac, and, ...
What is the chorionic bump on a first trimester sonogram?
Conclusions: The finding of a chorionic bump on the first-trimester sonogram is associated with a guarded prognosis for the early pregnancy (live birth rate <50%); it probably represents a small hematoma that bulges into the gestational sac, and, in our series, most patients had a history of infertility treatments.
Is bump size correlated with pregnancy outcome?
Results: The difference in outcomes between the patients with bumps and the healthy control subjects was statistically significant (7 live births versus 13 live births; P < .03), but the difference in outcomes between the patients with bumps and infertility control subjects was not statistically significant (7 live births versus 11 live births; P = .1). Bump size was not correlated with pregnancy outcome. In most patients with serial sonograms, the bump showed evolutionary changes typical for hematoma.
What is a chorionic bump?
A chorionic bump is a convex-shaped irregular bulge that protrudes from the choriodecidual surface into the gestational sac. It is significant to distinguish chorionic bump from subchorionic hemorrhage. The former is the choriodecidual membrane bulging into the gestational sac, whereas the latter is blood collection between chorion and deciduas [4]. It is a rare sonographic finding observed in the first-trimester obstetric ultrasound with a low incidence, from 1.5/1000 to 7/1000 pregnancies [5]. The average gestational age of diagnosis is approximately 11 weeks after the umbilical cord's appearance at the thicker end of the chorion frondosum [4,6]. The exact underlying etiology is unclear. However, the literature hypothesizes that the chorionic bump might be a hematoma, which has been consistently supported by sonographic findings and histopathological analysis. Baalman et al. postulated that the decidualized endometrium's extensive necrosis might be the mechanism behind chorionic bumps [1].
What is the primary imaging modality for the diagnosis of chorionic bump?
Ultrasonography is the primary imaging modality for the diagnosis. Early diagnosis might suggest the need to follow up with an ultrasound to observe the evolution in the chorionic bump and monitor the pregnancy's viability. The chorionic bump's echogenicity pattern varies, i.e., a central hypoechoic region surrounded by a peripheral hyperechogenic area, entirely hyperechoic, or isoechoic to the chorion [3]. Moreover, on color Doppler, it shows avascularity that favors the chorionic bump to be a hematoma.
Can chorionic bumps cause miscarriage?
The literature review suggests that chorionic bump is a cause of first-trimester pregnancy loss, and it doubles the miscarriage rate as compared to when there are no risk factors [3]. In this article, we present a series of six cases of the chorionic bump, which we diagnosed at our institute in the last four years.
Can chorionic bumps cause pregnancy loss?
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.
Is there a specific treatment for chorionic bump?
There is no specific management or guidelines for this condition. It remains unclear whether an intervention might reduce the miscarriage risk in affected patients; however, the chorionic bump might evolve and disappear as the pregnancy progresses [2]. In the various cases reported in the literature, treatment was carried out according to the initial presentation and findings, regardless of a chorionic bump. Nevertheless, it is advisable to keep a close follow-up with serial ultrasounds in the first trimester due to a higher incidence of miscarriage [9].
Is chorionic bump a hematoma?
The heterogeneous echogenicity, avascularity on ultrasound, and high signal intensity on T1-weighted MR images suggest that the chorionic bump might be a hematoma, further reinforcing hemorrhage finding on the histopathological exam [4]. For two cases, the histopathologic exams showed placental edema and gestational tissue (chorionic villi) [7]. In a case-control study, Silva et al. conducted a uterine artery Doppler in both groups for assessing the risk of abnormal placentation. Although the difference was not statistically significant, a higher value seen in cases might imply a higher risk of placental diseases in patients having a chorionic bump [6].
What is a chorionic bump?
A Chorionic Bump (CB), which has been identified as “an irregular, convex bulge from the choriodecidual surface into the first-trimester gestational sac ,” was first reported by Harris et al. in 2006 as an important finding in early first trimester pregnancy sonography as a risk factor for pregnancy loss, with live birth rate of less than 50% [1]. The cause of CB remains unclear and several assumptions have been proposed as to whether it is the cause of early demise or follows it [2]. The chorionic bump might represent the following: a hematoma, an area of hemorrhage, a non-embryonic gestation, or a demise of an embryo in a twin pregnancy [2], [5]. No clear pattern is detected using color and power Doppler examination. From 2006 to 2015, several studies have been conducted on CB including Arleo et al. [3] who provided a systematic review and meta-analysis of CB in pregnant patients and associated live birth rate, Harris et al. [1] who studied a prospective cohort, Sana et al. [4] who carried out a case–control study, as well as a few case reports [5], [6], [7], [8] and Joseph et al. [9] who published a retrospective cohort.
Is chorionic bump a first trimester finding?
However, considering the low incidence in both patients and the literature of CB, further studies on chorionic bumps and the risk of demise would be helpful for full delineation of this infrequent first-trimester sonographic finding.
What is the purpose of the study on chorionic bumps?
The aim of this study was to examine whether there is an increased risk of miscarriage in pregnancies with a chorionic bump.
Why do I have chorionic bumps?
The underlying pathophysiology of chorionic bumps is unknown. We speculate that they are due to hemorrhage within the trophoblast beneath the chorionic membrane. It may be that bleeding on the maternal side of the developing placenta results in a subchorionic hematoma as the blood can track between the chorionic villi and decidua into the endometrial cavity, causing little distortion of the extraembryonic anatomy. However, bleeding within the embryonic part of the placenta may not be able to track out of the shell of trophoblast so it occurs within a confined space, expanding where there is least resistance and bulging into the gestational sac.
What is the prevalence of chorionic bumps?
Data in the literature concerning chorionic bumps are limited, and the only previous report estimated the prevalence of a chorionic bump to be 0.7% with a live birth rate of 47% 1. The same study reported a two-fold increase in miscarriage rate compared with an infertility control group and a four-fold increase compared with the general pregnant population. Nine of the 15 patients in that series had a history of infertility and six had undergone fertility treatment for the index pregnancy. Our study confirmed an increased risk of miscarriage which was almost double that of our matched controls due to a higher rate of second-trimester miscarriages. Although the overall risk of miscarriage was lower in our study, it is still comparable with the previous study given the small number of cases. That study involved a smaller series and fewer controls and therefore data were not broken down according to gestational age at the time of miscarriage, but it also reported a relatively high second-trimester miscarriage rate (2/15 pregnancies).
How many women have chorionic bumps?
A total of 37 798 pregnancies were examined over the study period. The initial search identified 1146 scans in 904 pregnancies. After review of the archived images, 57 pregnancies with a chorionic bump were identified, giving an estimated prevalence of 0.15 (95% CI, 0.01–0.73)% of all pregnancies seen in the early pregnancy unit. A total of 22 929 women had intrauterine pregnancies with a visible gestational sac using ultrasound. Of women with a visible gestational sac, the presence of a chorionic bump was associated with higher maternal age and vaginal bleeding (33 vs 30 years ( P = 0.001) and 50.8% vs 30.3% ( P = 0.0008, chi-square test), respectively). Demographic and clinical features of the study group in comparison to matched controls are shown in Table 1.
What is the difference between chorionic bumps and matched controls?
Women presenting to early pregnancy units with a chorionic bump discovered at first-trimester ultrasound examination had approximately double the risk of miscarriage compared with matched controls, the difference being due to a greater number of miscarriages during the second trimester of pregnancy.
Can chorionic bumps cause miscarriage?
Women presenting to early pregnancy units with a chorionic bump discovered at first-trimester ultrasound examination can be counseled that there is evidence of an increased risk of miscarriage, with a higher rate in the second trimester. Due to the low prevalence of chorionic bumps, it is unlikely that a randomized trial of therapy could ever be adequately powered, so it remains to be seen whether any intervention can reduce the high miscarriage rate seen in affected pregnancies .
What is chorionic bump?
We describe a series of patients with a previously unreported sonographic finding, the chorionic “bump,” which is an irregular, convex bulge from the choriodecidual surface into the first‐trimester gestational sac. The pregnancy outcome is investigated in this series of patients and compared with the general population and infertility first‐trimester control groups. Methods. We prospectively noted a cohort of 15 cases with the chorionic bump on first‐trimester sonograms (in a total of 2178 patients) performed over 3 years at our institution (prevalence, 0.7%). We then compared pregnancy outcomes against 2 pregnant control groups (15 general, noninfertility patients and 15 infertility patients) who were maternal age and gestational age matched to our patient group. Results. The difference in outcomes between the patients with bumps and the healthy control subjects was statistically significant (7 live births versus 13 live births; P < .03), but the difference in outcomes between the patients with bumps and infertility control subjects was not statistically significant (7 live births versus 11 live births; P = .1). Bump size was not correlated with pregnancy outcome. In most patients with serial sonograms, the bump showed evolutionary changes typical for hematoma. Conclusions. The finding of a chorionic bump on the first‐trimester sonogram is associated with a guarded prognosis for the early pregnancy (live birth rate <50%); it probably represents a small hematoma that bulges into the gestational sac, and, in our series, most patients had a history of infertility treatments.
What is choriodecidual irregularity?
Choriodecidual irregularity in the first‐trimester gestational sac, or an unusual or bizarre shape of the early gestational sac, has been well described as a sign of threatened abortion by Nyberg et al 5 among others. Nyberg et al 5 reported a distorted sac shape to have 100% specificity for nonviability. We have, in contradistinction, encountered a focal bulge or bump in the choriodecidual reaction on occasion in our first‐trimester population, which, on the basis of our review, has a 2‐fold increase in miscarriage rate compared with infertility control patients and a 4‐fold increase in miscarriage rate compared with the general population, based on our small series.
