Examination of products of conception from previable human pregnancies.

Abstract

The incidence, aetiology, and mechanisms of spontaneous abortion are outlined. A simplified classification of products of conception specifically orientated for routine histopathological laboratories rather than research centres is presented. Its introduction should not in itself greatly increase the work load of a service laboratory already examining such material. Specific practical problems are discussed and these are related to the clinical situation. The importance is emphasised of proper examination of tissues from pregnancies aborting after diagnostic amniocentesis, as well as those from therapeutic terminations performed for fetal abnormality or disease. Special techniques are suggested for processing suspected procured abortions. Finally the value is stressed of routine examination of spontaneously aborted material in the current and future management of the patient, in the furtherance of our knowledge of fetal diseases and of some of the major contributory factors to perinatal morbidity and mortality.

Recurrent pregnancy losses and parental chromosome abnormalities: a review

“…Should pathological and cytogenctic examin-ation be recommended for uU spontaneous abortions when material is available? There is no doubt that information on the karyotype would be useful, but as Rushton (1981) has pointed out. the task of chromosomally evaluating all spontaneous abortions in the United Kingdom, with an estiniatcd 100 000 spontaneous abortions annually, would be a monumental one.…”

Early recurrent miscarriage: histology of conception products

“…Sections were only concidered suitable for review if large numbers of chorionic villi were present. The specimens were divided into three types according to the method described by Rushton (1981;1987): type I, in which the majority of villi showed microscopic hydatidiform change (this appearance was found by Rushton to show the highest correlation with chromosomal abnormalities); type 11, in which the majority of villi showed post-mortem M. H . Houwert-de Jong ef al.…”

The Nature and Causes of Spontaneous Abortions with Normal Karyotypes

“…The immunological enigma of pregnancy remains under close scrutiny, but is far from satisfactory resolution, the role of immunological factors in spontaneous abortions being unproven. Advances in our understanding of the major complications of potentially viable pregnancies, i.e., preeclamptic toxemia, fetal intrauterine growth retardation, and prematurity (Robertson, 1976;Sheppard and Bonnar, 1976;Rushton, 1981), suggest that a significant proportion of these disorders have their inception in early pregnancy, thus emphasizing that artificial temporal divisions of pregnancy have no comparable biological counter-parts. Thus reproductive wastage cannot, and should not, be compartmentalized by gestational age.…”