Histopathological study for the products of conception from a regional pathology laboratory in Southwestern Saudi Arabia: A 5-year retrospective study

Abstract

Introduction: Abortion is defined as the ending of a pregnancy before 20 weeks of gestation or the delivery of a fetus that weighs less than 500 grams. Histopathological examination of the products of conception (POC) candiagnose the underlying cause of abortion e.g., molar pregnancy and hydropic alterations. Methodology: Over a period of five years, from 2017 to 2022; a total number of 569 cases of first-trimester abortion curetted material were sent to the regional laboratory, Department of Histopathology, Al-Qunfudah, Saudi Arabia. Clinical data of each case, type of abortion, placental morphology, villus size, villus vascularity and histopathological findings of each POC sample were studied. Results: The mean age of the studied women was (32.74 ± 7.04 years), with a mean number of pregnancies of 4.68 ± 3.07 (range: 0 -25). Out of the studied POC samples n=355 (62.4%) were incomplete abortions, while inevitable abortion was the least frequent type n=15 (2.7%). There was a significant relationship between fibrin, Arias-Stella, hydrophobic changes, and fibrosis with villus size (p= 0.005, 0.001, 0.001, and 0.013, respectively). Additionally, villus vascularity was significantly associated with the histopathology findings; fibrin, fibrosis, Arias-Stella, and hydrophobic changes (p= 0.001, 0.005, 0.001, and 0.001, respectively). Conclusion: Our findings support that most abortions might be due to chromosomal abnormalities suggested by the significant prevalence of small and hypo-vascularized villi in the studied POC. Routine histopathological examination of all POC is mandatory to rule out critical conditions such as molar or ectopic pregnancy.