First-trimester miscarriage: A histopathological classification proposal

Abstract

Background Histopathology of first-trimester abortion products may be useful in document an intrauterine pregnancy, identifying an important pathology affecting the mother or the embryo and diagnosing conditions that are likely to recur in future pregnancies or that explain the adverse fetal outcome. Relevant information provided by histology is essential to determine the cause and to guide the patients with early pregnancy failure. Aims Histopathological classification proposal in first-trimester miscarriage. Methods Published pathological criteria in first-trimester abortion specimens were collected, standardized and focused into a comprehensive diagnosis. The idea was to create a comprehensive classification related to major pathophysiological processes. Thus, the histological criteria were grouped into 7 categories: i. Changes suggesting aneuploidy (CSA) or metabolic storage disease; ii. Embryo anomaly (EA); iii. Multifactorial (MF) causes; iv. Maternal causes (MC); v. Gestational trophoblastic disease, such as hydatidiform mole (HM) and non neoplastic lesions and neoplasms; vi. Ectopic pregnancy; vii. Other. So, a 6-years retrospective study of first-trimester spontaneous miscarriage were reviewed. Two groups were created: i. Study group include specimens with pathological diagnosis; ii. Control group incorporate specimens with pathological diagnosis and additional genetic study in order to validate pathological criteria. Results Pathological criteria concordance between inter-observers was generally good, with an excellent correlation in EA and HM categories. Despite greater inter-observer disagreement in the CSA and MC categories the correlation with the genetic results was very positive. Conclusion A standardized, reproducible and biologically comprehensive histopathological classification may improve fetal follow-up and couple's management.

Teorias do conhecimento e abordagens pedagógicas: influências na prática pedagógica do professor de educação superior

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Análise Jurídica Sobre O Incidente De Deslocamento De Competência Nos Casos De Violações Contra Os Direitos Humanos

“…Averígua-se a gestão da SJFMA como meio para fomento da sustentabilidade, tendo em vista que a SJFMA revela características de completude (associada com o significado "excelência") no tangente ao ODS 16 na vertente histórica e cultural. Isso mostra conexão tanto com a teoria sociointeracionista formulada por Vygotsky -a qual postula que a cultura, a linguagem e as interações sociais estimulam o desenvolvimento da aprendizagem (Lakomy, 2014;Nogueira;Leal, 2015) -quanto com a aprendizagem significativa explicitada por Ausubel -que defende a importância de se atribuir um significado na construção de conhecimentos (Ausubel;Novak;Hanesian, 1980;Nogueira;Leal, 2015).…”

Prevalence of Infectious Agents Causing Abortion in Pregnant Women Using Serological Tests and Histopathological Analysis

“…First-trimester specimens have very different compositions, making histopathological evaluation crucial for detecting previously undetected illnesses. The therapy of patients with sporadic and recurrent early pregnancy failure includes histopathology on a regular basis [11].…”