Relationship among maternal serum endocrinology, placental karyotype, and intervillous circulation in early pregnancy failure.
OBJECTIVE
To evaluate the relationship among maternal serum endocrinology, placental karyotype, and intervillous blood flow in missed miscarriage.


METHODS
Cross-sectional study of maternal serum, transvaginal ultrasound/Doppler, and placental cytogenetic and immunohistochemical investigations.


METHODS
Tertiary care academic hospital.


METHODS
One hundred fifty-two women with missed miscarriage between 7 and 13 weeks of gestation.


METHODS
Ultrasound features, placental intervillous circulation findings on color Doppler imaging, and maternal serum level of alpha-fetoprotein (AFP), beta-hCG, E(2), P, and inhibin A were compared retrospectively with placenta karyotype and hCG immunochemistry.


METHODS
Data were analyzed according to karyotype results, presence or absence of an intervillous circulation, and delay between fetal demise and evacuation.


RESULTS
The presence of intervillous blood flow and serum concentrations of the different hormones were independent of placental karyotype. Serum beta-hCG and P were significantly higher in cases with intervillous blood flow. No difference in immunostaining for beta-hCG was found between placental tissues from normal pregnancies and missed miscarriages, but significantly higher villous beta-hCG content was found on Western blotting in miscarriage with a recent fetal demise.


CONCLUSIONS
The excessive entry of maternal blood inside the placenta in the early stage of most miscarriages is unrelated to conceptus karyotype, and hCG features may reflect a temporary attempt of the trophoblast to stabilize after the initial oxidative insult.
Greenwold
Natalie
N
Academic Department of Obstetrics and Gynaecology, Royal Free and University College London Medical School, UCL Campus, London, United Kingdom.
Jauniaux
Eric
E
Gulbis
Beatrice
B
Hempstock
Joanne
J
Gervy
Christine
C
Burton
Graham J
GJ
D000022:Abortion, Spontaneous / Q000209:etiology*; D002454:Cell Differentiation; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood; D002824:Chorionic Villi / Q000098:blood supply*; D002869:Chromosome Aberrations; D003430:Cross-Sectional Studies; D004958:Estradiol / Q000097:blood; D005260:Female; D005865:Gestational Age; D006801:Humans; D007150:Immunohistochemistry; D007265:Inhibins / Q000097:blood; D007621:Karyotyping; D010920:Placenta / Q000648:ultrastructure*; D011247:Pregnancy / Q000097:blood*; D012039:Regional Blood Flow
D018997:Chorionic Gonadotropin, beta Subunit, Human; C422364:inhibin B; D004958:Estradiol; D007265:Inhibins