Arleo Elizabeth Kagan, Dunning Allison, Troiano Robert N
New York-Presbyterian Hospital/Weill Cornell Medical Center, New York, New York USA.
J Ultrasound Med. 2015 Apr;34(4):553-7. doi: 10.7863/ultra.34.4.553.
A chorionic bump on first-trimester sonography has been considered a risk factor for nonviability in pregnant patients with this rare finding, although the strength of this association has recently been questioned. We performed a systematic review and meta-analysis to summarize the association between a chorionic bump and nonviability.
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 5 studies, 2 studies with a total of 67 patients met inclusion criteria. These were combined with a study (n = 52) from our institution. Overall, the live birth rate was 62% (74 of 119). Fifty-one chorionic bump pregnancies were otherwise normal (ie, pregnancies in which a gestational sac, a yolk sac, and an embryo with a heartbeat was seen at some point), and in this subset, the live birth rate was 83% (42 of 51). There was no significant relationship found between vaginal bleeding and live birth (P = .857); there was no significant difference in bump volume between live birth and no live birth (P = .198); and for the subset analysis of pooled odds ratios for the relationship between live birth and history of infertility, there was no significant relationship found (P = .186).
A chorionic bump remains a risk factor for nonviability in pregnancy; however, if the pregnancy is otherwise normal, then most result in live birth.
孕早期超声检查发现的绒毛膜隆起被认为是出现这一罕见情况的孕妇发生胚胎停育的一个风险因素，尽管这种关联的强度最近受到了质疑。我们进行了一项系统评价和荟萃分析，以总结绒毛膜隆起与胚胎停育之间的关联。
进行了全面的文献检索。我们纳入了除病例报告之外的所有研究。使用随机效应模型进行荟萃分析。
在筛选了5项研究后，2项共纳入67例患者的研究符合纳入标准。这些研究与我们机构的一项研究（n = 52）合并。总体而言，活产率为62%（119例中的74例）。51例绒毛膜隆起妊娠在其他方面正常（即妊娠过程中在某些时间点可见妊娠囊、卵黄囊和有心跳的胚胎），在这一子集中，活产率为83%（51例中的42例）。未发现阴道出血与活产之间存在显著关系（P = 0.857）；活产组与未活产组之间的隆起体积无显著差异（P = 0.198）；对于活产与不孕史之间关系的合并比值比进行亚组分析，未发现显著关系（P = 0.186）。
绒毛膜隆起仍然是妊娠胚胎停育的一个风险因素；然而，如果妊娠在其他方面正常，那么大多数会导致活产。
