The role of hysteroscopic biopsy in obtaining specimens for cytogenetic evaluation in missed abortion prior to suction dilatation and curettage.
OBJECTIVE
To estimate whether hysteroscopic-guided biopsy of gestational sac(s) in first trimester missed abortion increases the sensitivity of detecting aneuploidy compared to washing and careful specimen collection after suction dilatation and curettage (D&C).


METHODS
Thirty-five patients with first trimester missed abortion of which 25 underwent 29 suction D&Cs and 10 underwent hysteroscopic-guided biopsy of 12 gestational sacs prior to suction D&C. The karyotype of products of conception specimens were analyzed by G-banding techniques.


RESULTS
The percentage of specimens with 46,XX, 46,XY and aneuploidy were not significantly different in the hysteroscopic group [4/12 (33.3%), 3/12 (25.0%) and 5/12 (41.7%)] compared with the D&C group [8/29 (27.6%), 5/29 (17.2%) and 16/29 (55.2%)]. Although parity differed significantly between groups, it did not hold in a multivariable logistic regression model built to estimate whether the parity, gestational age and specimen collection method predict the likelihood of detecting a 46,XX chromosomal complement.


CONCLUSIONS
Direct hysteroscopic-guided biopsies of gestational sac(s) do not increase the sensitivity of conventional cytogenetics for detecting aneuploidy when compared to specimens obtained by washing and microscopic identification of villi or fetal tissue after suction D&C.
Awonuga
Awoniyi O
AO
Division of Reproductive Endocrinology and Infertility, Wayne State University, Detroit, Michigan 48201, USA. niyiawonuga @ aol.com
Jelsema
Jodi
J
Abdallah
Mazen E
ME
Berman
Jay
J
Diamond
Michael P
MP
Puscheck
Elizabeth E
EE
D000030:Abortion, Missed / Q000235:genetics*; D000328:Adult; D000782:Aneuploidy; D001706:Biopsy / Q000379:methods*; D016009:Chi-Square Distribution; D004107:Dilatation and Curettage; D005260:Female; D006801:Humans; D015907:Hysteroscopy; D007621:Karyotyping; D016015:Logistic Models; D011247:Pregnancy; D012680:Sensitivity and Specificity; D013048:Specimen Handling / Q000379:methods*