Detection of Placental Chromosomal Aberrations in Early Spontaneous Abortionsin Correlation with the Histologic Findings

Abstract

Abstract Using a variety of molecular techniques, it has been established that loss of pregnancy occurs in one to two thirds of all fertilized embryos in the first trimester. In about 50% of the cases, chromosomal abnormalities are the cause of early spontaneous abortion. Several histological characteristics of the placenta, such as presence of villous stromal cavitations, fetal erythrocytes, umbilical cord, fetal tissue, etc. are suggested as predictive factors for aneuploidy. Two hundred and thirty one cases were analyzed in this prospective study, 50 cases were control artificial abortions and 181 cases were early spontaneous abortionsanalyzed in the period from May 2012 to December 2014. Standard histopathological analysis and molecular techniques based on polymerase chain reaction were used to analyze the samples. Usingmolecular techniques, aneuploidy was detected in 53.1% of the samples. The most frequently detected aneuploidy was trisomy 16, followed by trisomy 22, 21, 14 and 18. The molecular analysis also enabled distinction of maternal and paternal origin of the alleles. In the histopathological sample analysis, binary logistic regression analysis indicated the presence of trophoblastic proliferation (p=0.008) and the absence of fetal red blood cells (p=0.001) as independent significant factors in the prediction of aneuploidy in early spontaneous abortion. In conclusion, our results show that clinically relevant and accurate diagnosis of early spontaneous abortion which can determine its causecan only be achieved bya controlled process of selection of the material, histo-pathological and molecular analysis, followed bya necessary correlation of these results.