Routine Histopathological Analysis of the Products of Conception: Is there a Value?

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.