Routine histopathologic analysis of product of conception following first‐trimester spontaneous miscarriages

Abstract

By routine histopathologic assessment of products of first-trimester spontaneous miscarriages, important pathologies such as molar pregnancy and placental trophoblastic disease can be diagnosed. Histopathological assessment has great value in the identification of an ectopic pregnancy or infection when compared with clinical and laboratory findings.

The role of histopathological examination of the products of conception following first-trimester miscarriage in Erbil Maternity Hospital

“…6 Many diagnostic tools were used to determine the type of miscarriage and to differentiate it from other conditions such as ultrasound, quantitative beta-human chorionic gonadotropin (beta-hCG) testing, and histopathologic examination of the uterine products. 7 The tissue which passed by a spontaneous miscarriage or removed during the uterine evacuation is important to undergo histopathologic examination for detecting unsuspected conditions like molar or ectopic pregnancy and diagnosing surgical complications like the incomplete evacuation of the uterus. 8 There is controversy regarding the practice of routine histopathologic examination of tissue removed during the miscarriage.…”

“…8 There is controversy regarding the practice of routine histopathologic examination of tissue removed during the miscarriage. Some authorities 2,3,5,7,8 suggest that a sample of tissue from all uterine evacuations (either spontaneous or surgical/medical) should be submitted for histopathological assessment: first to confirm the pregnancy, second to exclude an ectopic pregnancy or gestational trophoblastic diseases and third to search for the causes of miscarriage. These researchers have tried to estimate the utility and cost-effectiveness of histopathologic examination of first-trimester miscarriage tissue.…”

“…These researchers have tried to estimate the utility and cost-effectiveness of histopathologic examination of first-trimester miscarriage tissue. 5,7 Some studies 3 , 5 have diagnosed other pathologies in tissue from first-trimester miscarriage such as exaggerated placental site, placental site trophoblastic nodule, and decidual tissue. The authors of these studies concluded that routine histopathologic examination of products of conceptions could lead to the diagnosis of important pathologies; more effectively identify ectopic pregnancies or infections than clinical or other laboratory criteria, and may reduce mortality.…”

The accuracy of first trimester ultrasound in the diagnosis of hydatidiform mole

“…The importance of this is highlighted by a recent study of 1606 women undergoing a surgical evacuation where HM was not suspected, where the incidence of HM was found to be 2.5% (40/1606) 16 . It follows that as not all women with a failed pregnancy undergo an ERPC, some cases of HM will inevitably go undetected, and it may be that the high PPV of ultrasound for this condition may be an important adjunct in raising the suspicion in cases where histological diagnosis is not possible, or is unclear.…”

Histopathological Changes in the Chorionic Villi and Endometrial Decidual Tissues in the Product of Conception of Spontaneous Abortion Cases

“…In agreement with previous studies the present study also has product of conception as the majority cases from those samples of spontaneous abortion. 10,11 Those studies were investigating the relation of histopathological findings with tissue samples obtained from first-trimester miscarriage, 11 and also exploring whether the routine histopathological examination is required to detect either an ectopic or molar pregnancy. 10,12 Moreover, the histopathological assessment has great value in the identification of different diseases compared to clinical and laboratory findings.…”