Document Detail

Can placental pathology explain second-trimester pregnancy loss and subsequent pregnancy outcomes?
MedLine Citation:
PMID:  18928989     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: This study sought to determine whether specific placental pathology may provide further insight into the mechanisms of second-trimester pregnancy loss, particularly in cases without inflammation. STUDY DESIGN: A blinded pathologist examined placentas from 90 patients with spontaneous second-trimester pregnancy loss and 17 controls who presented for induction of labor for fetal indications. Inflammation was staged and evidence of other vascular pathology recorded. Significant associations were determined by chi(2) analysis and Fisher's exact test. A secondary analysis examined losses without inflammation. Twelve patients with a subsequent pregnancy were also evaluated. RESULTS: Acute inflammation was more prevalent in cases than controls (P < .001). Sixty-seven percent of all cases and none of the controls showed a stage 2-3 inflammatory response. Histologic abruption was also more prevalent in cases than controls (P = .05). CONCLUSION: Second-trimester pregnancy loss is strongly associated with placental inflammation. Histologic abruption is likely another etiology. Future research should focus on subsequent pregnancy outcomes in these women based on initial placental pathology to help determine etiology and recurrence risk.
Sindhu K Srinivas; Linda M Ernst; Andrea G Edlow; Michal A Elovitz
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American journal of obstetrics and gynecology     Volume:  199     ISSN:  1097-6868     ISO Abbreviation:  Am. J. Obstet. Gynecol.     Publication Date:  2008 Oct 
Date Detail:
Created Date:  2008-10-20     Completed Date:  2008-11-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370476     Medline TA:  Am J Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  402.e1-5     Citation Subset:  AIM; IM    
Department of Obstetrics and Gynecology, University of Pennsylvania Health System, Philadelphia, PA, USA.
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MeSH Terms
Abortion, Spontaneous / pathology*
Case-Control Studies
Chorioamnionitis / pathology
Gestational Age
Inflammation / pathology
Logistic Models
Placenta / pathology*
Pregnancy Outcome*
Pregnancy Trimester, Second*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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