*   Ultrasound Division, ASL Roma B, Rome, Italy;
**   Reparto di ostetricia e ginecologia, Ospedale Fatebenefratelli San Pietro Rome, Italy.
***  Ultrasound Division, Ceprano Hospital, Ceprano, Italy. 

Case reports

These are 2 cases of endometrial polyps in the first trimester of pregnancy associated with embryo demise.

Case 1:

This is the case of a 32 years old patient (G1P0). The patient was asymptomatic before pregnancy. She presented with vaginal bleeding after 6 weeks of amenorrhea and ultrasound showed a regular yolk sac and vital embryo inside the gestational sac. Furthermore, a hyperechoic mass of 24 x 14 mm originating from the anterior uterine wall was bulging into the gestational sac. Color and Power Doppler showed no vascularity. Endometrial polyp was suspected. The patient stopped bleeding and she came back for her first trimester screening at 13 weeks when demised embryo was found. The embryo measured 23 mm corresponding to 9th week of pregnancy.

Uterine cavity revision and curettage were performed and the patient was scanned transvaginally after her first period. A suspicion of an endometrial polyp was raised. The polyp was smaller than in pregnancy probably due to less hormonal stimuli out of the pregnancy and/or for possible its partial removal during uterine cavity revision. The polyp was removed by hysteroscopy and following histology confirmed the diagnosis.

Images 1, 2, 3, 4: Image 1 shows demised embryo within gestational sac. Images 2, 3, 4 show endometrial polyp bulging into the gestational sac.