The predictive value of chorionic villus histology for identifying chromosomally normal and abnormal spontaneous abortions.
To evaluate the significance of placental histology, a collaborative histological and cytogenetic study on the products of 123 spontaneous abortions of 6-19 week pregnancies was performed. From each sample, 2-3 g was dissected randomly and analysed histologically with no prior knowledge of the karyotype. Chromosomes were prepared from the remaining chorionic villi after an overnight incubation in culture medium; they were analysed by Q- or G-banding. The frequency and type of chromosome anomalies detected are comparable to those seen in other studies. Altogether, 49.6% were chromosomally abnormal, trisomies predominating (49.2%), followed by polyploidy (27.9%) and monosomy X (14.5%). The histological classification failed for technical reasons in 11 cases (8.9%). To classify the remaining cases, 18 different histological criteria were considered independently by two pathologists. A definite diagnosis was not possible for 27 abortions (22.0%), and 50 were classified as being chromosomally abnormal. This proved to be correct in 36 (72.0%), but incorrect in as many as 14 (28.0%). No evidence for an abnormal karyotype was found histologically in samples from 35 abortuses. Nevertheless, 9 of them (25.7%) had an abnormal karyotype. The predictive value of chorionic villus histology seems to be inadequate, as only 62 of 112 samples were correctly classified by histology (55.4%). The value differs little from the a priori probability of an abnormal or normal karyotype in abortuses of corresponding gestational ages.
Minguillon
C
C
Abteilung für Paidopathologie und Placentologie, Universitätsklinikum Virchow der Freien Universität, Berlin, Germany.
Eiben
B
B
Bähr-Porsch
S
S
Vogel
M
M
Hansmann
I
I
D000022:Abortion, Spontaneous / Q000235:genetics* / Q000473:pathology; D000328:Adult; D015193:Chorionic Villi Sampling; D002869:Chromosome Aberrations; D005260:Female; D006801:Humans; D008423:Maternal Age; D010920:Placenta / Q000473:pathology*; D011237:Predictive Value of Tests; D011247:Pregnancy