Chromosomal abnormalities including triploidy, trisomy (reported for every chromosome), monosmy X (Turner's syndrome), among others.
Problems with mainintaing implantation including antiphospholipid antibody syndrome
Chromosomal abnormalities may result in fetal death with subsequent death of the placenta.
Unknown what effect chromosomal abnormalities have on the placenta's function.
Antiphospholipid antibody syndrome is associated with abnormal decidual vascularization and thrombosis of decidual vessels with abruption.
Ascending infection leads to membrane rupture and premature delivery.
Anatomic cervical incompetence can also lead to miscarriage.,
Human pregnancy generates large numbers of spontaneous losses.
Estimates of the percentages of conceptions that fail to reach term has increased with the advent of early detection methods.
Greater than 25% of pregnancies end spontaneously.
Current estimates are that approximately 50% of first trimester losses (by far the most common) are secondary to chromosomal abnormalities.
Increasing spontaneous abortion rate with age.
Some women are habitual aborters.
|General Gross Description|
An empty sac or disorganized embryonic tissues (identified by microscopy) may be secondary to early fetal demise.
Alternatively the fetus may be delivered within the amnionic sac followed by the placenta.
|General Microscopic Description|
Findings vary with etiology of the loss.
Common to all is an implantation site with acute hemorrhage and inflammation.
Decidualized endometrium is generally sloughed as well.
The villi may show infarct or intervillositis in cases associated with euploidy.
The villi may show a complex villus outline, trophoblastic inclusions, and calcifications in aneuploid gestations.
Histologic abnormalities can be demonstrated in the fetus.
Cotran RS, Kumar V, Robbins SL: Robbins Pathologic Basis of Disease. 5th ed. Philadelphia, W.B. Saunders, 1994, pp. 1078-9.
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||Synopsis by: Melinda Sanders M.D. (T89000M35250)