Embryoscopic demonstration of hemorrhagic lesions on the human embryo after placental trauma.
OBJECTIVE
The purpose of this study was to evaluate embryoscopically the effect of placental trauma on the human embryo.


METHODS
Patients undergoing elective first-trimester termination of pregnancy underwent transcervical embryoscopy both before and after chorionic villus sampling. If hemorrhagic lesions were not observed on the fetus after chorionic villus sampling, partial placental detachment was performed with a blunt instrument, and the fetus was again observed.


RESULTS
Hemorrhagic lesions were observed in 20 of 43 fetuses. In 13 of them, the lesions occurred after placental trauma with the chorionic villus sampling catheter alone (30%), whereas lesions were observed in the remaining seven patients after additional blunt placental disruption. The lesions were located most frequently on the cephalic region, and they grew in size during the observation period. Gestational age or amount of chorionic villus sampling tissue was not different between fetuses with or without lesions.


CONCLUSIONS
Placental trauma results in embryoscopically demonstrable hemorrhagic lesions on the human embryo. Whereas some of these lesions may be of no consequence, others may lead to permanent changes. If similar lesions occur in deeper tissues, they could cause disruptions in development and conceivably could be related to anomalies reported in infants born to women who have had chorionic villus sampling procedures. Embryoscopy affords the opportunity to study possible mechanisms involved in the occurrence of anomalies.
Quintero
R A
RA
Department of Obstetrics and Gynecology, Yale University School of Medicine, New Haven, Connecticut.
Romero
R
R
Mahoney
M J
MJ
Abuhamad
A
A
Vecchio
M
M
Holden
J
J
Hobbins
J C
JC
D002584:Cervix Uteri; D015193:Chorionic Villi Sampling; D004724:Endoscopy; D005260:Female; D005315:Fetal Diseases / Q000209:etiology*; D005865:Gestational Age; D006470:Hemorrhage / Q000209:etiology*; D006801:Humans; D010920:Placenta / Q000293:injuries*; D011247:Pregnancy