E-ISSN: 2619-9467

Contents    Cover    Publication Date: 08 Jul 2021
Year 2021 - Volume 31 - Issue 2

Open Access

Peer Reviewed

ORIGINAL RESEARCH
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Should All Abortion Materials Be Sent for Histopathological Evaluation?

  
J Clin Obstet Gynecol. 2021;31(2):35-9
DOI: 10.5336/jcog.2021-81117
Article Language: EN
Copyright Ⓒ 2020 by Türkiye Klinikleri. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
ABSTRACT
Objective: Partial hydatidiform mole is the type of mole in which a foetus and/or cardiac activity is seen. Clinical diagnosis of missed abortion and anembryonic gestation may cause the partial mole to be missed or misdiagnosed if a histopathologic examination is not carried out. Our objective in this study was to clarify whether it is really necessary to send all abortion materials for histopathological examination considering the rate of mole (complete/partial) among all abortion materials in a university hospital. Material and Methods: In this retrospective cohort study, we evaluated the clinical and histopathological results of 1,004 women with a clinical diagnosis of abortion that were diagnosed at the University of Kütahya Health Sciences Evliya Çelebi Hospital between January 2015 and December 2020. Results: Missed abortion was the most common diagnosis with 638 women (63.5%) among the abortion materials that were sent for histopathology. Complete mole was diagnosed in only one (1/1,004) woman, which was sent to pathology with a diagnosis of anembryonic gestation. The partial mole rate was 9/1,004 and most were diagnosed after a clinical diagnosis of anembryonic gestation (n=5, 55%). Placental villi were seen in 93% (934/1,004) but not in 6% (60/1,004) of the subjects (Arias-Stella reaction) on histopathology, which was possibly an ectopic pregnancy or a very early aborted early gestation in which placenta villi could not be identified. Partial and complete mole hydatidiform constituted 1% (9/1,004) and 0.1% (1,004) of the total cohort respectively. Conclusion: When taking into account the rate of mole hydatidiform (10/1,004) in a clinic where all abortion materials are being sent for histopathological examination routinely, we think that routine histopathological examination of abortion material seems reasonable and safe.
REFERENCES:
  1. Schorge JO, Schaer J, Halvorson LM, Homan BL, Bradshaw KD, Cunningham FG. First trimester abortion. In: Schorge JO, Williams JW, eds. Williams Gynecology. 1st ed. New York, NY, USA: McGraw-Hill; 2008.
  2. Hinshaw K, Fayyad A, Munjuluri P. The management of early pregnancy loss. RCOG Revised Guideline No. 25. 2005. (Kaynağa ulaşılabilecek link bilgisi eklenmelidir.)
  3. Alves C, Rapp A. Spontaneous Abortion. 2020 Jul 20. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021. [PubMed] 
  4. Heath V, Chadwick V, Cooke I, Manek S, MacKenzie IZ. Should tissue from pregnancy termination and uterine evacuation routinely be examined histologically? BJOG. 2000;107(6):727-30. [Crossref]  [PubMed] 
  5. Newlands ES, Paradinas FJ, Fisher RA. Recent advances in gestational trophoblastic disease. Hematol Oncol Clin North Am. 1999;13(1):225-44, x. [Crossref]  [PubMed] 
  6. Ozalp SS, Oge T. Gestational trophoblastic diseases in Turkey. J Reprod Med. 2013;58(1-2):67-71. [PubMed] 
  7. Biscaro A, Silveira SK, Locks Gde F, Mileo LR, da Silva Júnior JP, Pretto P. Frequência de mola hidatiforme em tecidos obtidos por curetagem uterina [Frequency of hydatidiform mole in tissue obtained by curettage]. Rev Bras Ginecol Obstet. 2012;34(6):254-8. Portuguese. [PubMed] 
  8. Berkowitz RS, Goldstein DP, Bernstein MR. Natural history of partial molar pregnancy. Obstet Gynecol. 1985;66(5):677-81. [PubMed] 
  9. Dhingra N, Punia RS, Radotra A, Mohan H. Arias-Stella reaction in upper genital tract in pregnant and non-pregnant women: a study of 120 randomly selected cases. Arch Gynecol Obstet. 2007;276(1):47-52. [Crossref]  [PubMed] 
  10. Palmer JR. Advances in the epidemiology of gestational trophoblastic disease. J Reprod Med. 1994;39(3):155-62. [PubMed] 
  11. Jeffers MD, O'Dwyer P, Curran B, Leader M, Gillan JE. Partial hydatidiform mole: a common but underdiagnosed condition. A 3-year retrospective clinicopathological and DNA flow cytometric analysis. Int J Gynecol Pathol. 1993;12(4):315-23. [Crossref]  [PubMed] 
  12. Altieri A, Franceschi S, Ferlay J, Smith J, La Vecchia C. Epidemiology and aetiology of gestational trophoblastic diseases. Lancet Oncol. 2003;4(11):670-8. [Crossref]  [PubMed] 
  13. Tasci Y, Dilbaz S, Secilmis O, Dilbaz B, Ozfuttu A, Haberal A. Routine histopathologic analysis of product of conception following first-trimester spontaneous miscarriages. J Obstet Gynaecol Res. 2005;31(6):579-82. [Crossref]  [PubMed] 
  14. Alsibiani SA. Value of histopathologic examination of uterine products after first-trimester miscarriage. Biomed Res Int. 2014;2014:863 482. [Crossref]  [PubMed]  [PMC] 
  15. Berkowitz RS, Cramer DW, Bernstein MR, Cassells S, Driscoll SG, Goldstein DP. Risk factors for complete molar pregnancy from a case-control study. Am J Obstet Gynecol. 1985;152(8):1016-20. [Crossref]  [PubMed] 
  16. Acaia B, Parazzini F, La Vecchia C, Ricciardiello O, Fedele L, Battista Candiani G. Increased frequency of complete hydatidiform mole in women with repeated abortion. Gynecol Oncol. 1988;31(2):310-4. [Crossref]  [PubMed] 
  17. Maisenbacher MK, Merrion K, Kutteh WH. Single-nucleotide polymorphism microarray detects molar pregnancies in 3% of miscarriages. Fertil Steril. 2019;112(4):700-6. [Crossref]  [PubMed]