Improved accuracy of hysteroembryoscopic biopsies for karyotyping early missed abortions

Ferro, Jaime; Martínez, Ma.Carmen; Lara, C.; Pellicer, António; Remohı́, J.; Serra, Vicente

doi:10.1016/s0015-0282(03)02195-2

Cited by 41 publications

(29 citation statements)

References 8 publications

(12 reference statements)

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“…Chromosomal anomaly is the most common cause of miscarriage in the first trimester with an incidence of approximately 29-75% [4][5][6][7][8][9] . Although the lower figures may be due to inclusion of, and the definition of, recurrent aborters used in these studies [6] , Stern et al [10] observed no differences in frequency of abnormal karyotype in POC from women with or without a history of recurrent spontaneous abortion.…”

Section: Discussionmentioning

confidence: 99%

The Role of Hysteroscopic Biopsy in Obtaining Specimens for Cytogenetic Evaluation in Missed Abortion prior to Suction Dilatation and Curettage

Awonuga

Jelsema

Abdallah

et al. 2010

Gynecol Obstet Invest

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Aim:To estimate whether hysteroscopic-guided biopsy of gestational sac(s) in first trimester missed abortion increases the sensitivity of detecting aneuploidy compared to washing and careful specimen collection after suction dilatation and curettage (D&C). Materials and Methods:Thirty-five patients with first trimester missed abortion of which 25 underwent 29 suction D&Cs and 10 underwent hysteroscopic-guided biopsy of 12 gestational sacs prior to suction D&C. The karyotype of products of conception specimens were analyzed by G-banding techniques. Results:The percentage of specimens with 46,XX, 46,XY and aneuploidy were not significantly different in the hysteroscopic group [4/12 (33.3%), 3/12 (25.0%) and 5/12 (41.7%)] compared with the D&C group [8/29 (27.6%), 5/29 (17.2%) and 16/29 (55.2%)]. Although parity differed significantly between groups, it did not hold in a multivariable logistic regression model built to estimate whether the parity, gestational age and specimen collection method predict the likelihood of detecting a 46,XX chromosomal complement. Conclusions:Direct hysteroscopic-guided biopsies of gestational sac(s) do not increase the sensitivity of conventional cytogenetics for detecting aneuploidy when compared to specimens obtained by washing and microscopic identification of villi or fetal tissue after suction D&C.

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Section: Discussionmentioning

confidence: 99%

The Role of Hysteroscopic Biopsy in Obtaining Specimens for Cytogenetic Evaluation in Missed Abortion prior to Suction Dilatation and Curettage

Awonuga

Jelsema

Abdallah

et al. 2010

Gynecol Obstet Invest

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“…Furthermore, others studied the selective embryonic and chorionic biopsies performed by hysteroembryoscopy immediately before the curettage procedure and its specimens were more accurate [7,8].…”

Section: Issn: 2454-3284mentioning

confidence: 99%

“…Researchers tested the role of hysteroscopy in improving the karyotyping for early missed miscarriages [8] concluded that direct hysteroembryoscopic biopsies were more accurate than the direct curettage material. In contrast, [24] found that direct hysteroscopic sampling did not improve the sensitivity of cytogenetics for aneuploidy detection when compared with conventional suction D&C.…”

Section: Author Contributionsmentioning

confidence: 99%

Hysteroscopic Evaluation of the Uterine Cavity in Women with First-Trimester Missed Miscarriage: Case Series

Altraigey¹,

Nosseir²,

Abbas³

et al. 2017

Journal of Gynecology Research

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The aim of this study was to identify the value of hysteroscopy in detection of the relationship between missed miscarriage and intrauterine pathologies. The study was held at the Department of Obstetrics and Gynaecology, Benha University. It included 90 women with 1 st trimester missed miscarriage who were examined by diagnostic hysteroscopy immediately before dilatation and curettage (D&C) and 6-8 weeks after D&C (second look hysteroscopy). Incomplete uterine septum was found in 22.2% of cases; 70% of them had a previous history of missed miscarriage. Intrauterine adhesions were found in 6.7% of cases before D&C and in 16.7% after D&C. In cases of missed miscarriage either before or after D&C, hysteroscopy is an easy and effective tool for diagnosis of the site of the sac and the presence of intrauterine pathology.Abstract

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“…In that case, endoscopic equipment is introduced through the cervix, and the procedure may be completed with evacuation of the products of conception. For this, larger equipment is often used, consisting of 0°or 30°hysteroscope, housed within a double flow sheath allowing for exchange of irrigation fluid (at body temperature and a pressure 40-120 mmHg) [50,51] and insertion of instruments (Bettocchi 3.6 mm 5 Ch operating sheath with 30°scope of 2 mm diameter, Karl Storz GmbH, Tuttlingen, Germany). The operator first localizes the gestational sac and surgically opens the chorionic membrane.…”

Section: Embryoscopymentioning

confidence: 99%

“…Ferro et al work intra-amniotically and published data on 68 patients presenting with missed abortion in an IVF program. Compared to material obtained from curettage, cytogenetic analysis of embryoscopic prelevations was more informative in 22% of cases [50]. Philipp et al reported abnormal standard karyotyping with G-banding in as many as 75% of 233 missed abortions.…”

Section: Embryoscopymentioning

confidence: 99%

The use of endoscopy in fetal medicine

Beck¹,

Pexsters²,

Gucciardo³

et al. 2010

Gynecol Surg

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We aimed to review the state of affairs in the field of embryo-fetoscopy as well as its instrumental requirements. Today, endoscopic procedures of limited complexity are easily possible within the amniotic cavity. Embryoscopy is typically done for diagnostic purposes, such as the demonstration of external anomalies very early in pregnancy and/or obtaining embryonic tissues in recurrent miscarriages. Fetoscopy is the direct visualization of the amniotic cavity from the second trimester onwards. Its principal indications are complications of monochorionic twinning and severe congenital diaphragmatic hernia. There is level I evidence that fetoscopic laser surgery for twintwin-transfusion syndrome is superior over amniodrainage. Fetoscopic endoluminal tracheal occlusion is done for severe diaphragmatic hernia. Whether tracheal occlusion yields better outcomes than expectant management during pregnancies is currently being investigated in a randomized trial. There are a number of less common procedures discussed as well. Overall, maternal risks of embryofetoscopy are minimal. The most frequent complication is rupture of the membranes and as a consequence preterm delivery. Fetal surgery seems safe and has, therefore, become a clinical reality. Although the stage of technical experimentation is over, most interventions remain investigational. Inclusion of patients into trials whenever possible should be encouraged, rather than building up casuistic experience.

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Improved accuracy of hysteroembryoscopic biopsies for karyotyping early missed abortions

Cited by 41 publications

References 8 publications

The Role of Hysteroscopic Biopsy in Obtaining Specimens for Cytogenetic Evaluation in Missed Abortion prior to Suction Dilatation and Curettage

The Role of Hysteroscopic Biopsy in Obtaining Specimens for Cytogenetic Evaluation in Missed Abortion prior to Suction Dilatation and Curettage

Hysteroscopic Evaluation of the Uterine Cavity in Women with First-Trimester Missed Miscarriage: Case Series

The use of endoscopy in fetal medicine

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