Autoamputation of cervical polyp presenting as spontaneous miscarriage

Cheryl Turner, RDMS., Eva Leinart, MD, PhD., Philippe Jeanty, MD, PhD.

Inner Vision Women's Ultrasound, Nashville, Tennessee, USA

Case report

A 35-year-old G1 P0 with unremarkable family or personal history was referred to our center for the ultrasound scan at 10 weeks of gestation due to vaginal bleeding.
The ultrasound examination showed a fetus with no apparent abnormalities measuring 9 weeks + 3 days according to the crown-rump length. There was no sign of subchorionic hematoma. The ultrasound revealed an isoechogenic mass filling the whole length of the cervical canal. The mass measured 50 x 10 mm and was well vascularized. Based on the ultrasound findings, our diagnosis was cervical polyp. This finding explained the continuous bleeding.

 Two weeks later at 11 weeks gestation the patient felt strong cramping in her lower abdomen which was followed by a profound bleeding with a discharge of some tissue. She presented to a local emergengy room where she was thought to have a spontaneus abortion and treated accordingly. She was sent for the follow-up ultrasound 2 days later.

At examination, a normal looking fetus measuring 11 weeks was seen. The cervical polyp was no longer visible. There was no sign of a subchorionic bleedin

We presume that the patient passed the autoamputated polyp at the time of the presumed miscarriage. Fortunately, the pregnancy remained intact and continued without any further complications.

Images 1,2: 10 weeks, transvaginal scans. Image 1 shows the fetus. Image 2 shows the uterus with the gestation sac and polyp inside the cervical canal.

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Images 3,4: Images of the cervix dialted with polyp (red).

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Image 5: Vascularization of the polyp demonstrated by color Doppler.

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Images 6,7: 12 weeks.

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Images 8,9: Vaginal scan of the cervix showing only slight dilation of the cervix, no sign of polyp.

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