Early Pregnancy Losses: Review of Nomenclature, Histopathology, and Possible Etiologies

Pinar, M. Halit; Gibbins, Karen J.; He, Mai; Kostadinov, Stefan; Silver, Robert M.

doi:10.1080/15513815.2018.1455775

Cited by 69 publications

(46 citation statements)

References 62 publications

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“…In this study, practically twothird of miscarriages were aneuploid, though this number is, likely, consequence of above average age of our center's patient population. While associations between miscarriages and specific conditions, such as antiphospholipid syndrome or uterine malformations, are well established [19,28], underlying mechanisms for most other non-chromosomal miscarriages are still only poorly understood.…”

Section: Discussionmentioning

confidence: 99%

Euploid miscarriage is associated with elevated serum C-reactive protein levels in infertile women: a pilot study

Weghofer

Barad

Darmon

et al. 2020

Arch Gynecol Obstet

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Purpose Increased serum C-protein (CRP) levels reduce fecundity in healthy eumenorrheic women with 1-2 pregnancy losses. Subclinical systemic inflammation may impede maternal immune tolerance toward the fetal semi-allograft, compromising implantation and early embryonic development. Some miscarriages with normal karyotypes could, therefore, be caused by inflammation. Whether pre-pregnancy CRP relates to karyotypes of spontaneously aborted products of conception (POCs) was investigated. Methods A study cohort of 100 infertile women with missed abortions who underwent vacuum aspirations followed by cytogenetic analysis of their products of conception tissue was evaluated at an academically affiliated fertility center. Since a normal female fetus cannot be differentiated from maternal cell contamination (MCC) in conventional chromosomal analyses, POC testing was performed by chromosomal microarray analysis. MCC cases and incomplete data were excluded. Associations of elevated CRP with first trimester pregnancy loss in the presence of a normal fetal karyotype were investigated. Results Mean patients' age was 39.9 ± 5.8 years; they demonstrated a BMI of 23.9 ± 4.6 kg/m 2 and antiMullerian hormone (AMH) of 1.7 ± 2.4 ng/mL; 21.3% were parous, 19.1% reported no prior pregnancy losses, 36.2% 1-2 and 6.4% ≥ 3 losses. Karyotypes were normal in 34% and abnormal in 66%. Adjusted for BMI, women with elevated CRP were more likely to experience euploid pregnancy loss (p = 0.03). This relationship persisted when controlled for female age and AMH. Conclusions Women with elevated CRP levels were more likely to experience first trimester miscarriage with normal fetal karyotype. This relationship suggests an association between subclinical inflammation and miscarriage.

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Section: Discussionmentioning

confidence: 99%

Euploid miscarriage is associated with elevated serum C-reactive protein levels in infertile women: a pilot study

Weghofer

Barad

Darmon

et al. 2020

Arch Gynecol Obstet

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“…As the only fetal cells directly in contact with the maternal system, the cellular function of trophoblast cells is important to the pathogenesis and progression of pregnancy. Thus, any disturbance of cell propensity, such as proliferation and apoptosis, migration and invasion, or differentiation, may affect embryo implantation, placental development, and establishment of the placental‐maternal circulation . Furthermore, abnormal proliferation, migration, invasion, and differentiation of trophoblast cells results in pathologic conditions in pregnancy, including fetal growth restriction, hypertensive disease of pregnancy, malignant hydatidiform mole, and choriocarcinoma .…”

Section: Discussionmentioning

confidence: 99%

Plasmacytoma variant translocation 1 (PVT1) regulates trophoblast viability, proliferation, and migration and is downregulated in spontaneous abortion

Qin

Chen

et al. 2018

American J Rep Immunol

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Human pregnancy is a complex biological process, and successful implantation is dependent on embryo hatching, trophoblast development, and proper maternal-fetal cross talk and immune regulation. 1 Spontaneous abortion is the spontaneous loss of pregnancy before the fetus has reached viability. The most common complication of pregnancy, the incidence of spontaneous pregnancy loss has been estimated to be 30%. 2,3 Spontaneous abortion may lead to serious injury and distress to the pregnant woman and her family and heavy cost to society. 4 In recent decades, a variety of molecules and cells have been implicated in spontaneous abortion, including eukaryotic translation initiation factor 5A (eIF5A), p53, peroxiredoxin 2, and others. 5-7 Despite advances in this field, the pathology and underlying mechanisms of spontaneous abortion remain poorly understood.As the only fetal cells in direct contact with the maternal system, trophoblast cells are the most important cells involved in embryo implantation and formation of a functional placenta. 8 Trophoblast cells are derived from fertilized eggs and exert an important role Problem: Human pregnancy is a complex biological process, and spontaneous abortion is the most common complication of pregnancy. LncRNAs have been identified that play key roles in a variety of human diseases. Recently, lncRNA PVT1 was reported to relate to the pathogenesis and progression of pregnancy. However, the role and underlying mechanism of PVT1 in trophoblast cell dysfunction in spontaneous abortion remain largely unknown. Method of study:The effects of PVT1, miR-424, and eIF5A on HTR8 cells and human villi tissues from spontaneous or induced abortions were investigated using CCK-8 assay, EdU assay, real-time polymerase chain reaction, Western blotting, cell transfection assays, cell migration assays, and luciferase reporter gene assays. Results: Overexpression of PVT1 promoted HTR8 cell viability, proliferation, and migration. Suppression of PVT1 promoted miR-424 expression, and miR-424 could modulate the effects of PVT1 in HTR8 cells. MiR-424 exerted its function via regulation of eIF5A expression in HTR8 cells. PVT1 and eIF5A expression were decreased and miR-424 was increased in clinical samples from spontaneous abortion, compared to samples from elective induced abortion. Conclusion: PVT1 regulates trophoblast cell function via modulation of a PVT1/miR-424/eIF5A pathway. K E Y W O R D S eukaryotic translation initiation factor 5A (eIF5A), microRNA-424 (miR-424), plasmacytoma variant translocation 1 (PVT1), spontaneous abortion, trophoblast cells

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“…Also, the natural history of early pregnancy loss, including temporal ordering of signs and symptoms in early pregnancy has not to be fully described [3]. The causes of early pregnancy losses have been reported in the literature as genetic causes, infectious causes, immunological causes, implantation abnormalities, anatomic abnormalities and endocrine disorders [4]. However, approximately 40% of early pregnancy losses are categorized as idiopathic [4].…”

Section: Introducti̇onmentioning

confidence: 99%

“…The causes of early pregnancy losses have been reported in the literature as genetic causes, infectious causes, immunological causes, implantation abnormalities, anatomic abnormalities and endocrine disorders [4]. However, approximately 40% of early pregnancy losses are categorized as idiopathic [4].…”

Section: Introducti̇onmentioning

confidence: 99%

Are neutrophil to lymphocyte ratio and platelet to lymphocyte ratio clinically useful for the prediction of early pregnancy loss?

Oğlak

Aydın

2020

Ginekol Pol

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Objectives: Red cell distribution width (RDW), mean platelet volume (MPV), plateletcrit (PCT), platelet distribution width (PDW), neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) have all been identified as systemic inflammatory markers. The aim of this study to investigate whether the use of systemic inflammatory markers can predict early pregnancy loss. Material and methods: A total of 137 patients with early pregnancy loss was compared with 148 participants in the control group who had given birth at term. In the study group, CBC values were included in the study at the time of referral to the hospital for routine follow-up, while patients did not experience early pregnancy loss. In the control group, CBC values of the patient before the seventh week of pregnancy were included in the study. results: There was no significant difference between the two groups in terms of RDW, MPV, PCT and PDW values. The NLR and PLR values were significantly higher in the early pregnancy loss group than the control group (p < 0.05). Conclusion: Our findings suggest that high NLR and PLR values are potent markers for the prediction of early pregnancy loss.

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Early Pregnancy Losses: Review of Nomenclature, Histopathology, and Possible Etiologies

Cited by 69 publications

References 62 publications

Euploid miscarriage is associated with elevated serum C-reactive protein levels in infertile women: a pilot study

Euploid miscarriage is associated with elevated serum C-reactive protein levels in infertile women: a pilot study

Plasmacytoma variant translocation 1 (PVT1) regulates trophoblast viability, proliferation, and migration and is downregulated in spontaneous abortion

Are neutrophil to lymphocyte ratio and platelet to lymphocyte ratio clinically useful for the prediction of early pregnancy loss?

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