Morphological verification of the first missed abortion

Abstract

Objective. The study aimed to compare the level of INF a2 immunoexpression in tissues obtained during medical abortion with the corresponding level of IFNa2 expression in a retained fetal egg tissues after the first missed abortion. The authors compared the anamnestic data on previous inflammatory diseases of the genital tract with the results of an extended morphological study of the material obtained during the evacuation of the contents of the uterine cavity during the first non-developing pregnancy in the first trimester.Materials and methods. The study included 15 patients with first-time missed abortions caused by a viral infection (6-8 weeks of pregnancy). All patients demonstrated either recurrent herpes simplex labialis/genitalis or PCR confirmed HSV, HPV, CMV. Exclusion criteria were recurrent miscarriage, blighted ovum, endocrinopathies, male factor infertility, and other causes of miscarriage. The comparison group included 20 women of the same age that chose to undergo a medical abortion.Results. In patients from the comparison group, the main producer of IFN a2 was syncytiotrophoblast as well as maternal decidual cells in the parietal endometrium and uteroplacental area. In the main group, manifested hematogenous infection (microabscesses, vasculitis, lymphocytic and macrophage infiltration) with dystrophy and necrosis of decidual maternal cells and secondary pathological changes in the placental villi were diagnosed, which led to a significant decrease in the IFN a2 immunoexpression in all the studied cells.Conclusion. The lack of anamnestic data on previous urogenital infections does not exclude the etiological role of the inflammatory component in the genesis of non-developing pregnancy. First-time occurred pregnancy loss requires adequate postoperative interferon therapy and a thorough examination of a couple.