Elizabeth Kagan Arleo MD, Presenter: Nothing to Disclose

Allison Dunning, Abstract Co-Author: Nothing to Disclose

Robert Nicholas Troiano MD, Abstract Co-Author: Nothing to Disclose

Chorionic bump, a convex bulge from the choriodecidual surface into the gestational sac on first trimester ultrasound, has been considered a risk factor for non-viability in pregnant patients with this rare finding, though the strength of this association has recently been questioned. We performed a systematic review and meta-analysis to summarize the association between chorionic bump and non-viability.

A comprehensive literature search was performed. We included all studies except case reports. A meta-analysis was performed using a random-effects model. 

After screening five studies, two studies with a total of 67 patients met inclusion criteria. This was combined with one study (N=52) from our institution (submitted for publication to JUM) of 52 patients, for a total of 119 unique patients. Overall, the live birth rate (LBR) was 62% (74/119). 51 chorionic bump pregnancies were otherwise normal (i.e., pregnancies in which a gestational sac, yolk sac and embryo with heartbeat was seen at some point), and in this subset, LBR was 83% (42/51). There was no significant relationship found between vaginal bleeding and live birth (p=0.857); no significant difference in bump volume between live birth and no live birth (p=0.19); and for subset analysis of pooled odds ratio for the relationship between live birth and history of infertility, there was no significant relationship found (p=0.186). 

Chorionic bump remains a risk factor for non-viability in pregnancy, however if the pregnancy is otherwise normal, then the majority result in live birth. 

If a first-trimester ultrasound demonstrates a chorionic bump, then the results of this meta-analysis suggest that if the pregnancy is otherwise normal, the majority will result in live birth.

Arleo, E, Dunning, A, Troiano, R, Chorionic Bump in Pregnant Patients and Associated Live Birth Rate: A Systematic Review and Meta-Analysis.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14006737.html