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Hum. Reprod. Advance Access published online on September 27, 2006
Human Reproduction, doi:10.1093/humrep/del128
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© The Author 2006. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org
Received March 1, 2006
Revised March 15, 2006
Accepted March 22, 2006

Article

Placental pathology of recurrent spontaneous abortion: the role of histopathological examination of products of conception in routine clinical practice: a mini review

P. Jindal 1, L. Regan 1, E.O. Fourkala 1, R. Rai 1, G. Moore 1, R.D. Goldin 1, and N.J. Sebire 2 *

1 Recurrent Miscarriage Unit, Department of Obstetrics & Gynaecology, St Mary’s Hospital, London, UK; Imperial College School of Medicine, London, UK
2 Department of Paediatric Pathology, Great Ormond Street Hospital, London, UK; Recurrent Miscarriage Unit, Department of Obstetrics & Gynaecology, St Mary’s Hospital, London, UK; Imperial College School of Medicine, London, UK

* To whom correspondence should be addressed.
N.J. Sebire, E-mail: sebirn{at}gosh.nhs.uk


  Abstract

BACKGROUND: Histopathological examination of products of conception from miscarriages is part of routine clinical practice. The extent of additional clinically relevant information provided by this investigation in the setting of recurrent spontaneous abortion remains uncertain. METHODS: Review of the literature was performed to identify studies reporting on findings of histological examination of routinely obtained products of conception in the setting of recurrent spontaneous abortion. The initial search identified 312 potential references, but 300 were excluded on further examination due to lack of data on specific histopathological findings in routine products of conception specimens from patients with recurrent spontaneous abortion. The 12 included studies indicated that such examination may identify hydatidiform moles, villous dysmorphic features suggesting fetal aneuploidy, chronic histiocytic intervillositis (CHI) and massive perivillous fibrin deposition and impaired trophoblast invasion. However, in most cases, morphological assessment cannot reliably determine the cause of the miscarriage or distinguish recurrent from sporadic miscarriage. Studies reporting on the use of additional immunohistochemical methods do not currently provide additional clinically useful diagnostic or prognostic information. CONCLUSION: Routine histological examination of products of conception in the setting of recurrent spontaneous abortion can provide important clinical information in a minority of cases.

Keywords: histopathology/products of conception/recurrent spontaneous abortion/review.
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