C. Salafia et al., PLACENTAL AND DECIDUAL HISTOLOGY IN SPONTANEOUS-ABORTION - DETAILED DESCRIPTION AND CORRELATIONS WITH CHROMOSOME-NUMBER, Obstetrics and gynecology, 82(2), 1993, pp. 295-303
Objectives: To determine the histopathology of failed pregnancy in cli
nically symptomatic women with no more than one prior pregnancy loss i
n order to provide baseline data, and to determine whether the histolo
gy of the conceptus in spontaneous abortions could predict a normal or
abnormal chromosome number. Methods: A review of all spontaneous abor
tions from which karyotypes were obtained between 1984-1991 yielded 22
4 cases in which maternal history indicated no more than one prior spo
ntaneous abortion, a reliable date of last menstrual period (LMP), and
available villous (221) and/or decidual/implantation site (175) patho
logy. Molar pregnancies were excluded. Results: Multivariate logistic
regression analysis showed a significant relationship between chromoso
me number and gestational age at loss as calculated from the LMP. Cons
idering this confounder, a villous circulation indicating fetal life t
o 11 or more weeks, chronic intervillositis and villous infarcts (each
P < .01), and decidual vasculitis (P < .05) were more frequent in chr
omosomally normal conceptions. Substituting possible variables into th
e logistic regression equation yielded predictions ranging from 88% li
kelihood of chromosomal abnormality to 97% likelihood of normal chromo
some number. Conclusions: Histology can assist in assessing whether a
spontaneous abortion is chromosomally normal or abnormal. There are ma
ny pathologic findings seen in spontaneous abortions regardless of kar
yotype; however, certain findings are more common in chromosomally nor
mal abortions. These data provide a baseline for study of the histopat
hology of habitual abortion.