title: Value of histopathologic examination of uterine products after first-trimester miscarriage.
abstract: The main rationale of routine histopathologic examination of products after first-trimester miscarriages is to detect an ectopic pregnancy or a molar pregnancy, which require further management. An alternative approach is to examine the products only when there is a definite indication. As there is no agreement, we aimed to study whether routine histopathological examination of tissues obtained after first-trimester miscarriage is of any clinical value in our populations. Medical records of all (558) patients with a diagnosis of first-trimester miscarriage over 4 years (2007-2010) at King Abdulaziz University Hospital, Jeddah, Saudi Arabia, were reviewed. Histopathologic examination confirmed products of conception in 537 (96.2%) patients, no products of conception in 17 (3%) patients, molar pregnancy in 2 (0.4%) patients, and decidual tissues without chorionic villi (Arias-Stella reaction) in 2 (0.4%) patients. After clinical correlation, only one unsuspected partial molar pregnancy was diagnosed by histopathology examination. Conclusion is that it does not appear reasonable to perform histopathological examination routinely after all first-trimester miscarriages in our studied population. We recommend that histopathological examination be performed in select instances: when the diagnosis is uncertain, when fewer tissues have been obtained during surgery, when unexpected pathology was seen, when ultrasound suggests a molar pregnancy, or when patients are considered at high risk for trophoblastic disease.
authors: Department of Obstetrics and Gynaecology, Faculty of Medicine, King Abdulaziz University, P.O. Box 122413, Jeddah 21332, Saudi Arabia.
authors: Sharifa Ali
authors: SA
authors: Alsibiani
mesh_terms: D000022:Abortion, Spontaneous / Q000175:diagnosis / Q000503:physiopathology*; D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D006828:Hydatidiform Mole / Q000175:diagnosis / Q000473:pathology; D008875:Middle Aged; D010336:Pathology / Q000379:methods*; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D012189:Retrospective Studies; D012529:Saudi Arabia; D014599:Uterus / Q000473:pathology*; D055815:Young Adult