Routine histopathological analysis of the products of conception: Is there a value?

Abstract

Background: Spontaneous miscarriage is one of the two most common problems encountered in the first trimester of pregnancy. The value of histopathological analysis of products of conception (POC) obtained as a result is a source of controversy. The aim of this study is to evaluate the histopathological characteristics of suspected POC following the first-trimester miscarriage and determine the clinical value of such histopathological analyses. Materials and Methods: This is a retrospective study of the histopathological analysis of POC over a period from January 1 st to December 31 st of 2016 carried out in the histopathology laboratory of a university teaching hospital. Materials for the study were POC obtained following spontaneous first trimester miscarriage and received in our laboratory. Relevant information about the patients was retrieved from the laboratory database and matched with laboratory request forms and copies of histopathology reports archived in the laboratory. Obtained data were analyzed by simple statistical methods. Results: The most common clinical diagnosis on admission was incomplete abortion ( n = 52; 48.6%), followed by complete abortion ( n = 31; 29.0%); the lowest was blighted ovum ( n = 1; 0.9%). The predominant histopathological type was normal POC which constituted 73 cases (68.2%). Other histopathological diagnoses include hydatidiform mole (9, 8.4%) and no evidence of conception (15, 14%). Clinical and ultrasound evaluation missed 2 (22.2%) of the 9 histopathologically diagnosed hydatidiform moles. Conclusion: Histopathological analysis of POC helps to diagnose molar pregnancies and other conditions which can be missed by clinical and ultrasound evaluation. Therefore, routine histopathological analysis of POC is advocated.

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

“…POC with hydropic changes shows enlarged chorionic villi with pale edematous cores (5). POC with an Arias Stella reaction Compared to a study performed in Nigeria conducted by Hayi and Onyishi [25] reported normal POC constituted the most common histopathological diagnosis at 73 (68.2%); these results disagree with our results in normal POC, which was 59 (64.1%) in seronegative aborted women. Arias Stella reaction was eight (7.5%), which is higher than our results in seronegative aborted women with POC with Arias Stella reaction, which was three (3.2%); variation may be due to the geographical area and population differences.…”

“…Products of conception (POC) passed spontaneously or evacuated surgically or medically are usually submitted to histopathological investigation, which entails a gross and microscopic examination of tissues received in the histopathology laboratory [25]. The predominant histopathological diagnosis was normal POC, which constituted 59 (64%) in seronegative women.…”