Routine histopathological analysis of the products of
conception following the first trimester abnormal intrauterine pregnancy
Y. Tascí, S. Dilbaz, O. Seçilmis, B. Dilbaz, A. Haberal
Department of Obstetrics and Gynaecology, SSK Maternity and
Women’s Health Teaching Hospital, Ankara, Turkey
Objective: To evaluate the histopathological findings of
tissue samples collected at termination of pregnancy and surgical uterine
evacuation in the first trimester.
Materials and method: This is a retrospective study of
patients admitted in the Early Pregnancy Clinic in a 12-month period with the
diagnosis of incomplete abortion (n=970), fetal death or missed abortion (n=636)
in the first trimester. The abnormal pregnancies were terminated and the tissue
samples were sent for histopathological diagnosis. Association of pre-operative
clinical diagnosis and the postoperative histological results was analysed.
Results: Uterine evacuation was performed in cases of
incomplete abortion (n=970, %60.4). Surgical pregnancy termination was performed
in cases of intrauterine fetal death or missed abortion (n=636, %39.6).
Histopathological examination revealed the products of conception in 1119
patients (%69.7) while hydropic changes were diagnosed in 33 patients (%2.5).
Complete hydatidiform mole was detected in only seven cases (%0.43). Exaggerated
placental site and placental site trophoblastic nodule was detected in two cases
(%0.12). Decidual tissue without chorionic villi was reported in 272 patients
(%16.9) that raised the suspicion of presence of other pathology. The patients
were called back for clinical examination, ultrasound assessment and -hCG level
measurements. An intact ectopic pregnancy was found in two of them.
Conclusion: By routine histopathological assessment of
products of abnormal intrauterine pregnancies, important pathologies such as
molar pregnancy and placental trophoblastic disease can be diagnosed.
Histopathological assessment can be alarming for an ectopic pregnancy or
infection if it is evaluated with clinical and laboratory findings.