Abortion, Placentas of Trisomies, and Immunological Considerations of Recurrent Reproductive Failure

  • Kurt Benirschke
  • Peter Kaufmann

Abstract

For the present discussion, an abortion or miscarriage is designated a conceptus that is expelled before the 20th week of gestation. That is important to state at the outset, as the pathological features of failed pregnancies differ markedly in specimens obtained later in gestation. In the United States, terminations before 20 weeks constitute abortions; later gestations are premature deliveries. A pregnancy of 20 weeks is legally at the dividing line; it is considered a gestation with an “embryo” (which may be treated as a surgical specimen) or, later, with a “fetus,” whose examination constitutes an autopsy. The terminology employed in publications and statistics differs widely and is not the same in different countries. For example, Vogel in Germany (1969, 1992) considered an abortion to be an expelled fetus of less than 1,000 g. He differentiated between embryonic and fetal (15–28 weeks) abortion. In many countries, legal viability is considered to be attained only at 28 weeks of gestation when the fetus has attained approximately 1,000 g in weight, but that is not so in the United States. Byrne et al. (1985), in a study of early fetal deaths, considered all specimens less than 28 weeks gestation. For these reasons it is difficult to place the studies of Vogel (1969, 1992) into context with current terminology. Hutchon (1998) reviewed the complex terminology of this topic and proposed (with concurrence of a British Study Group on terminology) that the term abortion be replaced with miscarriage for all types under discussion. Most truly spontaneous abortions occur before 12 weeks of gestation, and most result from chromosomal errors in the conceptus. Relatively few really spontaneous abortions occur between 12 and 20 weeks of gestation. Thereafter, between 20 and 30 weeks, another type of premature spontaneous termination becomes prevalent, that which is primarily caused by ascending infection with chorioamnionitis; infection is relatively uncommon before 20 weeks. These types of termination are fundamentally different processes with vastly different pathological findings.

Keywords

Spontaneous Abortion Hypertonic Saline Recurrent Spontaneous Abortion Hydatidiform Mole Legal Abortion 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. Abaci, E and Aterman, K.: Changes of the placenta and embryo in early spontaneous abortion. Am. J. Obstet. Gynecol. 102: 252–263, 1968.PubMedGoogle Scholar
  2. Adinolfi, M., Davies, A., Sharif, S., Soothill, P. and Rodeck, C.: Detection of trisomy 18 and Y-derived sequences in fetal nucleated cells obtained by transcervical flushing. Lancet 342: 403–404, 1993.PubMedCrossRefGoogle Scholar
  3. Aksel, S.: Immunologic aspects of reproductive disease. J.A.M.A. 268: 2930–2934, 1992.PubMedCrossRefGoogle Scholar
  4. Alvarez, H.: Diagnosis of hydatidiform mole by transabdominal placental biopsy. Am. J. Obstet. Gynecol. 95: 538–541, 1966.PubMedGoogle Scholar
  5. Anderson, A.B.M. and Turnbull, A.C.: Changes in amniotic fluid, serum and urine following the intra-amniotic injection of hypertonic saline. Acta Obstet. Gynecol. Scand. 47: 1–21, 1968.CrossRefGoogle Scholar
  6. Anonymous: Anshan Department of Obstetrics and Gynecology: fetal sex prediction by sex chromatin of chorionic villi cells during early pregnancy. Chin. Med. J. 1: 117–126, 1975.Google Scholar
  7. Anonymous: Abortion USA. Lancet 1:879–880, 1989. Antonarakis, S.E.: Diagnosis of genetic disorders at the DNA level. N. Engl. J. Med. 320: 153–163, 1989.Google Scholar
  8. Ayers, L.R., Drosman, S. and Saltzstein, S.L.: Iatrogenic para-cervical implantation of fetal tissue during therapeutic abortion: a case report. Obstet. Gynecol. 37: 755–760, 1971.PubMedGoogle Scholar
  9. Babaknia, A., Parmley, T.H., Burkman, R.T., Atienza, M.F. and King, T.M.: Placental histopathology of midtrimester termination. Obstet. Gynecol. 53: 583–586, 1979.PubMedGoogle Scholar
  10. Baergen, R.N., Castillo, M.M., Mario-Singh, B., Stehly, A.J. and Benirschke, K.: Embolism of fetal brain tissue to the lungs and the placenta. Pediatr. Pathol. Lab. Med. 17: 159–167, 1997.PubMedCrossRefGoogle Scholar
  11. Bahado-Singh, R.O., Kliman, H., Feng, T.Y., Hobbins, J., Copel, J.A. and Mahoney, M.J.: First-trimester endocervical irrigation: feasibility of obtaining trophoblast cells for prenatal diagnosis. Obstet. Gynecol. 85: 461–464, 1995.PubMedCrossRefGoogle Scholar
  12. Bahar, A.M., Alkarmi, T., Kamel, A.S. and Sljivic, V.: Anticardiolipin and antinuclear antibodies in patients with unexplained recurrent abortions. Ann. Saudi Med. 13: 535–540, 1993.PubMedGoogle Scholar
  13. Balasch, J., Reverter, J.C., Fâbregues F., Tàssies, D., Rafel, M., Creus, M. and Vanrell, J.A.: First-trimester repeated abortion is not associated with activated protein C resistance. Hum. Reprod. (Oxf.) 12: 1094–1097, 1997.CrossRefGoogle Scholar
  14. Barela, A.I., Kleinman, G.E., Golditch, I.M., Menke, D.J., Hogge, W.A. and Golbus, M.S.: Septic shock with renal failure after chorionic villus sampling. Am. J. Obstet. Gynecol. 154: 1100–1102, 1986.PubMedGoogle Scholar
  15. Beer, A.E. and Billingham, R.E.: The Immunobiology of Mammalian Reproduction. Prentice Hall, Englewood Cliffs, 1976.Google Scholar
  16. Bengtsson, L.P. and Stormby, N.: The effect of intraamniotic injection of hypertonic sodium chloride in human mid-pregnancy. Acta Obstet. Gynecol. Scand. 41: 115–123, 1962.CrossRefGoogle Scholar
  17. Benn, P.: Trisomy 16 and trisomy 16 mosaicism: a review. Am. J. Med. Genet. 79: 121–133, 1998.PubMedCrossRefGoogle Scholar
  18. Bennett, P, Vaughan, J., Henderson, D., Loughna, S. and Moore, G.: Association between confined placental trisomy, fetal uni-parental disomy, and early intrauterine growth retardation. Lancet 340: 1284–1285, 1992.PubMedCrossRefGoogle Scholar
  19. Besley, G.T.N., Ferguson-Smith, M.E., Frew, C., Morris, A. and Gilmore, D.H.: First trimester diagnosis of Gaucher disease in a fetus with trisomy 21. Prenatal Diagn. 8: 471–474, 1988.CrossRefGoogle Scholar
  20. Bianchi, D.W., Wilkins-Haug, L.E., Enders, A.C. and Hay, E.D.: Origin of extraembryonic mesoderm in experimental animals: relevance to chorionic mosaicism in humans. Am. J. Med. Genet. 46: 542–550, 1993.PubMedCrossRefGoogle Scholar
  21. Bischoff, F.Z., Lewis, D.E., Nguyen, D.D., Murrell, S., Schober, W., Scott, J., Simpson, J.L. and Elias, S.: Prenatal diagnosis with use of fetal cells isolated from maternal blood: five-color fluorescent in situ hybridization analysis on flow-sorted cells for chromosomes X, Y,13,18, and 21. Am. J. Obstet. Gynecol. 179: 203–209, 1998.PubMedCrossRefGoogle Scholar
  22. Bogart, M.H., Pandian, M.R. and Jones, O.W.: Abnormal maternal serum chorionic gonadotropin levels in pregnancies with fetal chromosome abnormalities. Prenatal Diagn. 7: 623–630, 1987.CrossRefGoogle Scholar
  23. Bogart, M.H., Golbus, M.S., Sorg, N.D. and Jones, O.W.: Human chorionic gonadotropin levels in pregnancies with aneuploid fetuses. Prenatal Diagn. 9: 379–384, 1989.CrossRefGoogle Scholar
  24. Bose, R., Cheng, H., Sabbadini, E., McCoshen, J., Mahadevan, M.M. and Fleetham, J.: Purified human early pregnancy factor from preimplantation embryo possesses immunosuppressive properties. Am. J. Obstet. Gynecol. 160: 954–960, 1989.PubMedGoogle Scholar
  25. Botto, L.D., Olney, R.S., Mastroiacovo, P., Khoury, M.J., Moore, C.A., Alo, C.J., Costa, R, Edmonds, L.D., Flood, T.J, Harris, J.A., Howe, H.L., Olsen, C.L., Panny, S.R. and Shaw, G.M.: Chorionic villus sampling and transverse digital deficiencies: evidence for anatomic and gestational-age specificity of the digital deficiencies in two studies. Am. J. Med. Genet. 62: 173–178, 1996.PubMedCrossRefGoogle Scholar
  26. Boué, J.G. and Boué, A.: Fréquence des aberrations chromosomiques dans les avortements spontanés humains. C.R. Acad. Sci. Paris 269: 283–288, 1969.Google Scholar
  27. Brambati, B. and Varotto, F.: Infection and chorionic villus sampling. Lancet 2: 609, 1985.CrossRefGoogle Scholar
  28. Brandenburg, H., Los, F.J. and Veld, P.I.: Clinical significance of placenta-confined nonmosaic trisomy 16. Am. J. Obstet. Gynecol. 174: 1663–1664, 1996.PubMedCrossRefGoogle Scholar
  29. Breed, A., Mantingh, A., Govaerts, L., Booger, A., Anders, G. and Laurini, R.: Abnormal karyotype in the chorion, not confirmed in a subsequently aborted fetus. Prenatal Diagn. 6: 375–377, 1986.CrossRefGoogle Scholar
  30. Bruyere, H.J., Arya, S., Kozel, J.S., Gilbert, E.F., Fitzgerald, J.M., Reynolds, J.F., Lewin, S.O. and Opitz, J.M.: The value of examining spontaneously aborted human embryos and placenta. Birth Defects 23: 169–178, 1987.Google Scholar
  31. Burton, B.K., Schulz, C.J. and Burd, L.I.: Limb anomalies associated with chorionic villus sampling. Obstet. Gynecol. 79: 726–730, 1992.PubMedGoogle Scholar
  32. Byrne, J., Warburton, D., Kline, J., Blanc, W. and Stein, Z.: Morphology of early fetal deaths and their chromosomal characteristics. Teratology 32: 297–315, 1985.PubMedCrossRefGoogle Scholar
  33. Carr, D.H.: Chromosomal studies in spontaneous abortions. Obstet. Gynecol. 26: 308–326, 1965.PubMedGoogle Scholar
  34. Cashner, K.A., Christopher, C.R. and Dysert, G.A.: Spontaneous fetal loss after demonstration of a live fetus in the first trimester. Obstet. Gynecol. 70: 827–830, 1987.PubMedGoogle Scholar
  35. Castle, D. and Bernstein, R.: Cytogenetic analysis of 688 couples experiencing multiple spontaneous abortions. Am. J. Med. Genet. 29: 549–556, 1988.PubMedCrossRefGoogle Scholar
  36. Cates, W., Ory, H.W., Rochat, R.W. and Tyler, C.W.: The intrauterine device and deaths from spontaneous abortion. N. Engl. J. Med. 295: 1155–1159, 1976.PubMedCrossRefGoogle Scholar
  37. Cauchi, M.N., Koh, S.H., Tait, B., Mraz, G., Kloss, M. and Pepperell, R.J.: Immunogenetic studies in habitual abortion. Aust. N.Z. J. Obstet. Gynaecol. 27: 52–54, 1987.PubMedCrossRefGoogle Scholar
  38. Cheung, S.W., Crane, J.P, Kyine, M. and Cui, M.Y.: Direct chromosome preparations from chorionic villi: a method for obtaining extended chromosomes and recognizing mosaicism confined to the placenta. Cytogenet. Cell Genet. 45: 118–120, 1987.PubMedCrossRefGoogle Scholar
  39. Chi, J.G., Lee, S.K., Suh, Y.L. and Park, S.H.: Sequential Atlas of Human Development. Korea Medical Publishing, Seoul, 1992.Google Scholar
  40. Chieri, P.R. and Aldini, A.J.R.: Feasibility of placental biopsy in the second trimester for fetal diagnosis. Am. J. Obstet. Gynecol. 160: 581–583, 1989.PubMedGoogle Scholar
  41. Christie, J.L., Anderson, A.B.M., Turnbull, A.C. and Beck, J.S.: The human placenta and membranes: a histological and immunofluorescent study of the effects of intra-amniotic injection of hypertonic saline. J. Obstet. Gynaecol. Br. Commonw. 73: 399–409, 1966.PubMedCrossRefGoogle Scholar
  42. Creasy, M.R., Crolla, J.A. and Alberman, E.D.: A cytogenetic study of human spontaneous abortions using banding techniques. Hum. Genet. 31: 177–196, 1976.PubMedCrossRefGoogle Scholar
  43. D’Alton, M.E., Malone, ED., Chelmov, D., Ward, B.E. and Bianchi, D.W.: Defining the role of fluorescence in situ hybridization on uncultured amniocytes for prenatal diagnosis. Am. J. Obstet. Gynecol. 176: 769–776, 1997.PubMedCrossRefGoogle Scholar
  44. Daniel, A., Ng, A., Kuah, K.B., Reiha, S. and Malafiej, R: A study of early amniocentesis for prenatal cytogenetic diagnosis. Prenatal Diagn. 18: 21–28, 1998.CrossRefGoogle Scholar
  45. Darney, P.D., Atkinson, E. and Hirabayashi, K.: Uterine perforation during second-trimester abortion by cervical dilation and instrumental extraction: a review of 15 cases. Obstet. Gynecol. 75: 441–444, 1990.PubMedGoogle Scholar
  46. Dawood, M.Y. and Jarrett, J.C.: Prolonged intrauterine retention of fetal bones after abortion causing infertility. Am. J. Obstet. Gynecol. 143: 715–717, 1982.PubMedGoogle Scholar
  47. Debus, O., Koch, H.G., Kurlemann, G., Sträter, R., Vielhaber, H., Weber, P. and Nowak-Göttle, U.: Factor V Leiden and genetic defects of thrombophilia in childhood porencephaly. Arch. Dis. Child. Fetal Neonatal Ed. 78:F121—F124,1998.Google Scholar
  48. DeLozier-Blanchet, C., Francipane, L., Ebener, J., Cox, J. and Extermann, R: Cytogenetic discrepancies between fetus and placenta: a frequent cause of reproductive pathologies? (abstract). Placenta 14:A. 14, 1993.Google Scholar
  49. Dickey, R.P., Olar, T.T., Taylor, S.N., Curole, D.N. and Matulich, E.M.: Relationship of small gestational sac crown-rump length differences to abortion and abortus karyotypes. Obstet. Gynecol. 79: 554–557, 1992.PubMedGoogle Scholar
  50. Doss, B.J., Greene, M.F., Hill, J., Heffner, L.J., Bieber, F.R. and Genest, D.R.: Massive chronic intervillositis associated with recurrent abortions. Hum. Pathol. 26: 1245–1251, 1995.PubMedCrossRefGoogle Scholar
  51. Eckman, T.R. and Carrow, L.A.: Placental lesions in sponta- neous abortion. Am. J. Obstet. Gynecol. 84: 222–228, 1962.PubMedGoogle Scholar
  52. Edwards, R.G., Howe, C.W.S. and Johnson, M.H.: Immunobiology of Trophoblast. Cambridge University Press, Cambridge, 1975.Google Scholar
  53. Eiben, B., Bartels, I., Bähr-Porsch, S., Borgmann, S., Gatz, G., Gellert, G., Goebel, R., Hammans, W., Hentemann, M., Osmers, R., Rauskolb, R. and Hansmann, I.: Cytogenetic analysis of 750 spontaneous abortions with the direct-preparation method of chorionic villi and its implications for studying genetic causes of pregnancy wastage. Am. J. Hum. Genet. 47: 656–663, 1990.PubMedGoogle Scholar
  54. Eiben, B., Hammans, W. and Goebel, R.: Chorionic villus sampling versus early amniocentesis. Lancet 350: 1253–1254, 1997.PubMedCrossRefGoogle Scholar
  55. Elias, S., Price, J., Dockter, M., Wachtel, S., Tharapel, A., Simpson, J.L. and Klinger, K.W.: First trimester prenatal diag-nosis of trisomy 21 in fetal cells from maternal blood. Lancet 340: 1033, 1992.PubMedCrossRefGoogle Scholar
  56. Enders, A.C. and King, B.F.: Formation and differentiation of extraembryonic mesoderm in the rhesus monkey. Am. J. Anat. 181: 327–340, 1988.PubMedCrossRefGoogle Scholar
  57. Eroglu, G., Betz, G. and Torregano, C.: Impact of histocompatibility antigens on pregnancy outcome. Am. J. Obstet. Gynecol. 166: 1364, 1369, 1992.Google Scholar
  58. Falik-Borenstein, T.C., Korenberg, J.R. and Schreck, R.R.: Confined placental mosaicism: prenatal and postnatal cytogenetic and molecular analysis, and pregnancy outcome. Am. J. Med. Genet. 50: 51–56, 1994.PubMedCrossRefGoogle Scholar
  59. Firth, H.V., Boyd, P.A., Chamberlain, E, MacKenzie, I.Z., Lindenbaum, R.H. and Huson, S.M.: Severe limb abnormalities after chorion villus sampling at 56–66 days’ gestation. Lancet 337: 762–763, 1992.CrossRefGoogle Scholar
  60. Firth, H.V., Boyd, RA., Chamberlain, RE, MacKenzie, I.Z., Morris-Kay, G.M. and Huson, S.M.: Analysis of limb reduction defects in babies exposed to chorionic villus sampling. Lancet 343: 1069–1071, 1994.PubMedCrossRefGoogle Scholar
  61. Fox, H.: Histological classification of tissue from spontaneous abortions: a valueless exercise? Histopathology 22: 599–600, 1993.PubMedCrossRefGoogle Scholar
  62. Fraser, E.J., Grimes, D.A. and Schulz, K.F.: Immunization as therapy for recurrent spontaneous abortion: a review and meta-analysis. Obstet. Gynecol. 82: 854–859, 1993.PubMedGoogle Scholar
  63. Frigoletto, F.D. and Pokoly, T.B.: Electrolyte dynamics in hyper-tonic saline-induced abortions. Obstet. Gynecol. 38: 647–652, 1971.PubMedGoogle Scholar
  64. Froster, U.G. and Jackson, L.: Limb defects and chorionic villus sampling: results from an international registry, 1992–1994. Lancet 347: 489–494, 1996.PubMedCrossRefGoogle Scholar
  65. Fujikura, T., Froehlich, L.A. and Driscoll, S.G.: A simplified anatomic classification of abortions. Am. J. Obstet. Gynecol. 95: 902–905, 1966.PubMedGoogle Scholar
  66. Fujikura, T., Ezaki, K. and Nishimura, H.: Chorionic villi and syncytial sprouts in spontaneous and induced abortions. Am. J. Obstet. Gynecol. 110: 547–555, 1971.PubMedGoogle Scholar
  67. Fukunaga, M., Ushigome, S. and Fukunaga, M.: Spontaneous abortions and DNA ploidy. An application of flow cytometric DNA analysis in detection of non-diploidy in early abortions. Mod. Pathol. 6: 619–624, 1993.PubMedGoogle Scholar
  68. Gänshirt-Ahlert, D., Burschyk, M., Garritsen, H.S.E, Helmer, L., Miny, R, Horst, J., Schneider, H.P.G. and Holzgreve, W.: Magnetic cell sorting and the transferrin receptor as potential means of prenatal diagnosis from maternal blood. Am. J. Obstet. Gynecol. 166: 1350–1355, 1992.PubMedGoogle Scholar
  69. Gant, N.F.: Recurrent Spontaneous Abortion. Supplement 21 to Williams Obstetrics. J.A. Pritchard, P.C. MacDonald and N.F. Gant, eds., pp. 1–11. Appleton & Lange, East Norwalk, 1989.Google Scholar
  70. Geisler, M. and Gropp. A.: Zur Methode der Züchtung von Abortmaterial für Chromosomenuntersuchungen. (Zugleich Mitteilung über die Beobachtung einer B-Trisomie bei Abortus). Geburtsh. Frauenheilkd. 27: 113–126, 1967.Google Scholar
  71. Geisler, M., Kleinebrecht, J. and Degenhardt, K.-H.: Histologische Analysen von triploiden Spontanaborten. Humangenetik 16: 283–294, 1972.PubMedGoogle Scholar
  72. Gill, T.J., Wegmann, T.G. and Nisbet-Brown, E.: Immunoregulation and Fetal Survival. Oxford University Press, New York, 1987.Google Scholar
  73. Gleicher, N.: Antiphospholipid antibodies and reproductive failure: what they do and what they do not do; how to, and how not to treat! Hum. Reprod. (Oxf.) 12: 13–16, 1997.CrossRefGoogle Scholar
  74. Göcke, H., Schwanitz, G., Muradow, I. and Zerres, K.: Pathomorphologie und Genetik in der Frühschwangerschaft. Pathologe 6: 249–259, 1985.PubMedGoogle Scholar
  75. Goldberg, J.D. and Wohlferd, M.M.: Incidence and outcome of chromosomal mosaicism found at the time of chorionic villus sampling. Am. J. Obstet. Gynecol. 176: 1349–1353, 1997.PubMedCrossRefGoogle Scholar
  76. Granat, M., Aloni, T., Makler, A. and Dar, H.: Autosomal translocation in an apparently normospermic male as a cause of habitual abortion. J. Reprod. Med. 26: 52–55, 1981.PubMedGoogle Scholar
  77. Griffin, D.K., Millie, E.A., Redline, R.W., Hassold, T.J. and Zaragoza, M.V.: Cytogenetic analysis of spontaneous abortions: comparison of techniques and assessment of the incidence of confined placental mosaicism. Am. J. Med. Genet. 72: 297–301, 1997.PubMedCrossRefGoogle Scholar
  78. Gustavii, B.: Studies on accidental intravascular injection in extra-amniotic saline induced abortion and a method for reducing this risk. J. Reprod. Med. 8: 70–74, 1972.PubMedGoogle Scholar
  79. Gustavii, B.: Studies on the mode of action of intra-amniotically and extra-amniotically injected hypertonic saline in therapeutic abortion. Acta Obstet. Gynecol. Scand. Suppl. 25: 1–22, 1973.Google Scholar
  80. Gustavii, B. and Brunk, U.: A histological study of the effect on the placenta of intra-amniotically and extra-amniotically injected hypertonic saline in therapeutic abortion. Acta Obstet. Gynecol. Scand. 51: 121–125, 1972.CrossRefGoogle Scholar
  81. Handyside, A.H.: Mosaicism in the human preimplantation embryo. Reprod. Nutr. Dev. 36: 643–649, 1996.PubMedGoogle Scholar
  82. Harrison, R.G., Jones, C.H. and Jones, E.P.: A pathological presomite human embryo. J. Pathol. Bacteriol. 92: 583–584, 1966.PubMedCrossRefGoogle Scholar
  83. Hassold, T., Chen, N., Funkhouser, J., Jooss, T., Manuel, B., Matsuura, J., Matsuyama, A., Wilson, C., Yamana, J.A. and Jacobs, RA.: A cytogenetic study of 1,000 spontaneous abortions. Ann. Hum. Genet. 44: 151–178, 1980.PubMedCrossRefGoogle Scholar
  84. Hatch, M., Kline, J., Levin, B., Hutzler, M. and Warburton, D.: Paternal age and trisomy among spontaneous abortions. Hum. Genet. 85: 355–361, 1990.PubMedCrossRefGoogle Scholar
  85. Hecht, E: The placenta in trisomy 18 syndrome: report of 2 cases. Obstet. Gynecol. 22: 147–148, 1963.PubMedGoogle Scholar
  86. Henderson, D.J., Bennett, ER., Rodeck, C.H., Gau, G.S., Blunt, S. and Moore, G.E.: Trophoblast from anembryonic pregnancy has both a maternal and paternal contribution to its genome. Am. J. Obstet. Gynecol. 165: 98–102, 1991.PubMedGoogle Scholar
  87. Herbst, R. and Multier, A.-M.: Structures pathologiques du placenta examinées au microscope électronique: premières observations des villosités de l’oeuf abortif humain. Gynécol. Obstet. (Paris) 70: 369–376, 1971.Google Scholar
  88. Heritage, D.W., English, S.C., Young, R.B. and Chen, A.T.L.: Cytogenetics of recurrent abortions. Fertil. Steril. 29: 414–417, 1978.PubMedGoogle Scholar
  89. Hem, W.M.: Correlation of fetal age and measurements between 10 and 26 weeks of gestation. Obstet. Gynecol. 63: 26–32, 1984.Google Scholar
  90. Hertig, A.T. and Sheldon, W.H.: Minimal criteria required to prove prima facie case of traumatic abortion or miscarriage: an analysis of 1,000 spontaneous abortions. Ann. Surg. 117: 596–606, 1943.PubMedCrossRefGoogle Scholar
  91. Hertig, A.T., Rock, J., Adams, E.C. and Menkin, M.C.: Thirty-four fertilized human ova, good, bad and indifferent, recovered from 210 women of known fertility: a study of biologic wastage in early human pregnancy. Pediatrics 23: 202–211, 1959.PubMedGoogle Scholar
  92. Hertz-Picciotto, I. and Samuels, S.J.: Incidence of early loss of pregnancy. N. Engl. J. Med. 319: 1483–1484, 1988.PubMedCrossRefGoogle Scholar
  93. Hill, J.A., Polgar, K., Harlow, B.L. and Anderson, D.J.: Evidence of embryo-and trophoblast-toxic cellular immune response(s) in women with recurrent spontaneous abortion. Am. J. Obstet. Gynecol. 166: 1044–1052, 1992.PubMedGoogle Scholar
  94. Hill, J.A., Melling, G.C. and Johnson, P.M.: Immunohistochemical studies of human uteroplacental tissues from first-trimester spontaneous abortion. Am. J. Obstet. Gynecol. 173: 90–96, 1995.PubMedCrossRefGoogle Scholar
  95. Hogge, W.A., Surti, U., Kochmar, S.J., Mowery-Rushton, P. and Cumbie, K.: Molecular cytogenetics: an essential component of modern prenatal diagnosis. Am. J. Obstet. Gynecol. 175: 352–357, 1996.PubMedCrossRefGoogle Scholar
  96. Holzgreve, W., Gänshirt-Ahlert, D., Burschyk, M., Horst, J., Miny, P., Gal, A. and Pohlschmidt, M.: Detection of fetal DNA in maternal blood by PCR. Lancet 335: 1220–1221, 1990.PubMedCrossRefGoogle Scholar
  97. Honoré, L.H., Dill, F.J. and Poland, B.J.: The association of hydatidiform mole and trisomy 2. Obstet. Gynecol. 43: 232–237, 1974.PubMedGoogle Scholar
  98. Honoré, L.H., Dill, F.J. and Poland, B.J.: Placental morphology in spontaneous humans abortuses with normal and abnormal karyotypes. Teratology 14:151–166, 1976.Google Scholar
  99. Honoré, L.H., Lin, C.C. and Bamforth, J.S.: Spontaneous abortion with uncommon forms of trisomy: a clinicopathologic study of fifteen cases (abstract P41). Five cases of trisomy 15 in first trimester spontaneous abortion: gross and microscopic pathology (abstract P42). Teratology 37: 458–459, 1989.Google Scholar
  100. Horn, L.-C., Rosenkranz, M. and Bilek, K: Wertigkeit der Plazentahistologie für die Erkennung genetisch bedingter Aborte. Z. Geburtshilfe Perinatol. 195: 47–53, 1991.PubMedGoogle Scholar
  101. Howat, A.J., Beck, S., Fox, H., Harris, S.C., Hill, A.S., Nicholson, C.M. and Williams, R.A.: Can histopathologists reliably diagnose molar pregnancy ? J. Clin. Pathol. 46: 599–602, 1993.PubMedCrossRefGoogle Scholar
  102. Huber, C.P., Melin, J.R. and Vellios, E: Changes in chorionic tissue of aborted pregnancy. Am. J. Obstet. Gynecol. 73: 569–578, 1957.PubMedGoogle Scholar
  103. Hustin, J., Schaaps, J.P. and Lambotte, R.: Anatomical studies of the utero-placental vascularization in the first trimester of pregnancy. Trophoblast Res. 3: 49–67, 1988.Google Scholar
  104. Hutchon, D.J.R.: Understanding miscarriage of insensitive abortion: time for more defined terminology. Am. J. Obstet. Gynecol. 179: 397–398, 1998.PubMedCrossRefGoogle Scholar
  105. Infante-Rivard, C., David, M., Gauthier, R. and Rivard, G.-E.: Lupus anticoagulants, anticardiolipin antibodies, and fetal loss. N. Engl. J. Med. 325: 1063–1066, 1992.CrossRefGoogle Scholar
  106. Jacobs, RA., Szulman, A.E., Funkhouser, J., Matsuura, J.S. and Wilson, C.C.: Human triploidy: relationship between parental origin of the additional haploid complement and development of partial hydatidiform mole. Ann. Hum. Genet. 46: 223–231, 1982.PubMedCrossRefGoogle Scholar
  107. Jaffin, H., Kerenyi, T. and Wood, E.C.: Termination of missed abortion and the induction of labor in midtrimester pregnancy. Am. J. Obstet. Gynecol. 84: 602–608, 1962.PubMedGoogle Scholar
  108. Jewett, J.F.: Two deaths from mid-trimester abortion. N. Engl. J. Med. 288: 47–48, 1973.PubMedCrossRefGoogle Scholar
  109. Johnson, P.M., Chia, K.V., Hart, C.A., Griffith, H.B. and Francis, W.J.A.: Trophoblast membrane infusion for unexplained recurrent miscarriage. Br. J. Obstet. Gynaecol. 95: 342–347, 1988.PubMedCrossRefGoogle Scholar
  110. Johnson, M.P., Drugan, A., Koppitch, F.C., Uhlmann, W.R. and Evans, M.I.: Postmortem chorionic villus sampling is a better method for cytogenetic evaluation of early fetal loss than culture of abortus material. Am. J. Obstet. Gynecol. 163: 1505–1510, 1990.PubMedGoogle Scholar
  111. Jurkovic, I. and Muzelak, R.: Frequency of pathologic changes in the young human chorion in therapeutic abortions of normal pregnancies: a report of 500 cases studied histologically. Am. J. Obstet. Gynecol. 108: 382–386, 1970.PubMedGoogle Scholar
  112. Jurukovski, J.N.: Complications following legal abortions. Proc. R. Soc. Med. 62: 830–831, 1969.PubMedGoogle Scholar
  113. Kaali, S.G., Szigetvari, I.A. and Bartfai, G.S.: The frequency and management of uterine perforations during first-trimester abortions. Am. J. Obstet. Gynecol. 161: 406–408, 1989.PubMedGoogle Scholar
  114. Kaeser, O.: Studien an menschlichen Aborteiern mit besonderer Berücksichtigung der frühen Fehlbildungen and ihrer Ursachen. Schweiz. Med. Wochenschr. 79:509–515, 780–785, 803–805, 1050–1056, 1979–1084, 1949.Google Scholar
  115. Kaffe, S., Benn, P.A. and Hsu, L.Y.F.: Fetal blood sampling in investigation of chromosome mosaicism in amniotic fluid cell culture. Lancet 2: 284, 1988.PubMedCrossRefGoogle Scholar
  116. Kajii, T., Ferrier, A., Niikawa, N., Takahara, H., Ohama, K. and Avirachan, S.: Anatomic and chromosomal anomalies in 639 spontaneous abortuses. Hum. Genet. 55: 87–98, 1980.PubMedCrossRefGoogle Scholar
  117. Kalousek, D.K.: Anatomic and chromosome anomalies in specimens of early spontaneous abortion-7 year experience. Birth Defects 23: 153–168, 1987.PubMedGoogle Scholar
  118. Kalousek, D.K. and Barrett, I.: Confined placental mosaicism and stillbirth. Pediatr. Pathol. 14: 151–159, 1994.PubMedCrossRefGoogle Scholar
  119. Kalousek, D.K. and Dill, F.J.: Chromosomal mosaicism confined to the placenta in human conceptions. Science 221: 665–667, 1983.PubMedCrossRefGoogle Scholar
  120. Kalousek, D. and McGillivray, B.: Confined placental mosaicism and intrauterine survival of trisomy 13 and 18 (abstract 828). Am. J. Hum. Genet. 41: A278, 1987.Google Scholar
  121. Kalousek, D.K., Barrett, I.J. and McGillivray, B.C.: Placental mosaicism and intrauterine survival of trisomies 13 and 18. Am. J. Hum. Genet. 44: 338–343, 1989.PubMedGoogle Scholar
  122. Kalousek, D.K., Fitch, N. and Paradice, B.A.: Pathology of the Human Embryo and Previable Fetus. An Atlas. Springer-Verlag, New York, 1990.CrossRefGoogle Scholar
  123. Kao, S.-M., Tang, G.-C., Hsieh, T.-T., Young, K.-C., Wang, H.-C. and Pao, C.C.: Analysis of peripheral blood of pregnant women for the presence of fetal Y chromosome-specific ZFY gene deoxyribonucleic acid sequences. Am. J. Obstet. Gynecol. 166: 1013–1019, 1992.PubMedGoogle Scholar
  124. Kazy, Z., Rozovsky, I.S. and Bakharev, V.A.: Chorion biopsy in early pregnancy: a method for early prenatal diagnosis for inherited disorders. Prenatal Diagn. 2: 39–45, 1982.CrossRefGoogle Scholar
  125. Keeling, J.W.: Fetal Pathology. Churchill Livingstone, Edinburgh, 1994.Google Scholar
  126. Kellokumpu-Lehtinen, P. and Pelliniemi, L.J.: Sex ratio of human conceptuses. Obstet. Gynecol. 64: 220–222, 1984.PubMedGoogle Scholar
  127. Kingdom, J., Sherlock, J., Rodeck, C. and Adinolfi, M.: Detection of trophoblast cells in transcervical samples collected by lavage or cytobrush. Obstet. Gynecol. 86: 283–288, 1995.PubMedCrossRefGoogle Scholar
  128. Kirby, D.R.S., McWhirter, K.G., Teitelbaum, M.S. and Darlington, C.D.: A possible immunological influence on sex ratio. Lancet 2: 139–140, 1967.PubMedCrossRefGoogle Scholar
  129. Knapp, L.A., Ha, J.C. and Sackett, G.P.: Parental MHC antigen sharing and pregnancy wastage in captive pigtailed macaques. J. Reprod. Immunol. 32: 73–88, 1996.PubMedCrossRefGoogle Scholar
  130. Knoth, M. and Larsen, J.F.: Ultrastructure of a human implantation site. Acta Obstet. Gynecol. Scand. 51: 385–393, 1972.CrossRefGoogle Scholar
  131. Kouvalainen, K. and Österlund, K.: Placental weights in Down’s syndrome. Ann. Med. Exp. Fenn. 45: 320–322, 1967.PubMedGoogle Scholar
  132. Kovacs, B.W., Shahbahrami, B. and Comings, D.E.: Studies of human germinal mutations by deoxyribonucleic acid hybridization. Am. J. Obstet. Gynecol. 160: 798–804, 1989.PubMedGoogle Scholar
  133. Kovats, S., Main, E.K., Librach, C., Stubblebine, M., Fisher, S.J. and DeMars, R.: A class I antigen, HLA-G, expressed in human trophoblast. Science 248: 220–223, 1990.PubMedCrossRefGoogle Scholar
  134. Krawczun, M.S., Jenkins, E.C., Masia, A., Kunaporn, S., Stark, S.L., Duncan, C.J., Sklower, S.L. and Rudelli, R.D.: Chromosomal abnormalities in amniotic fluid cell cultures: a comparison of apparent pseudomosaicism in Chang and RPMI-1640 media. Clin. Genet. 35: 139–145, 1989.PubMedCrossRefGoogle Scholar
  135. Kubatova, A. and Trnka, V.: Induced abortions of 8 to 12 weeks pregnancy: evaluation of methods and histological findings in decidua and chorionic villi. Acta Univ. Carol. Med. (Prague) 13: 483–491, 1967.Google Scholar
  136. Kuchinka, B.D., Kalousek, D.K., Lomax, B.L., Harrison, K.J. and Barrett, I.J.: Interphase cytogenetic analysis of single cell suspension prepared from previously formalin-fixed and paraffin-embedded tissues. Mod. Pathol. 8: 183–186, 1995.PubMedGoogle Scholar
  137. Kuhlmann, R.S., Werner, A.L., Abramowicz, J., Warsof, S.L., Arrington, J. and Levy, D.L.: Placental histology in fetuses between 18 and 23 weeks’ gestation with abnormal karyotype. Am. J. Obstet. Gynecol. 163: 1264–1270, 1990.PubMedGoogle Scholar
  138. Kulazenko, V.P. and Kulazenko, L.G.: Pathomorphological changes in an early spontaneous abortus with triploidy (69,XXX). Hum. Genet. 32: 211–215, 1976.PubMedCrossRefGoogle Scholar
  139. Kuliev, A.M.: Cytogenetic investigation of spontaneous abortions. Humangenetik 12: 275–283, 1971.PubMedCrossRefGoogle Scholar
  140. Kundsin, R.B., Falk, L., Hertig, A.T. and Home, H.W.: Acyclovir treatment of twelve unexplained infertile couples. Int. J. Fertil. 32: 200–204, 1987.PubMedGoogle Scholar
  141. Kwak, J.Y.H., Gilman-Sachs, A. and Beaman, K.D.: Reproductive outcome in women with recurrent spontaneous abortions of alloimmune and autoimmune causes: preconception versus postconception treatment. Am. J. Obstet. Gynecol. 166: 1787–1798, 1992.PubMedGoogle Scholar
  142. Ladefoged, C.: Hydrop degeneration: a histopathological investigation of 260 early abortions. Acta Obstet. Gynecol. Scand. 59: 509–512, 1980.CrossRefGoogle Scholar
  143. Lawson, H.W., Atrash, H.K. and Franks, A.L.: Fatal pulmonary embolism during legal induced abortion in the United States from 1972 to 1985. Am. J. Obstet. Gyneco1. 162: 986–990, 1990.Google Scholar
  144. Letters to the Editor: Antiphospholipid antibodies and fetal loss. N. Engl. J. Med. 326: 951–954, 1992.CrossRefGoogle Scholar
  145. Lea, R.G., Al-Sharekh, N., Tulppala, M. and Critchley, H.O.D.: The immunolocalization of bd-2 at the maternal-fetal inter-face in healthy and failing pregnancies. Hum. Reprod. (Oxf.) 12: 153–158, 1997a.CrossRefGoogle Scholar
  146. Lea, R.G., Tulppala, M. and Critchley, H.O.D.: Deficient syncytiotrophoblast tumor necrosis factor-a characterizes failing first trimester pregnancies in a subgroup of recurrent miscarriage patients. Hum. Reprod. (Oxf.) 12: 1313–1320, 1997b.CrossRefGoogle Scholar
  147. Letters to the Editor. Lancet 337: 1091–1092, 1991.CrossRefGoogle Scholar
  148. Li, L. and Smialek, J.E.: Sudden death due to rupture of ectopic pregnancy concurrent with therapeutic abortion. Arch. Pathol. Lab. Med. 117: 698–700, 1993.PubMedGoogle Scholar
  149. Lichtig, C., Korat, A., Deutch, M. and Brandes, J.M.: Decidual vascular changes in early pregnancy as a marker for intrauterine pregnancy. Am. J. Clin. Pathol. 90: 284–288, 1988.PubMedGoogle Scholar
  150. van Lijnschoten, G., Arends, J.W. and Geraedts, J.P.M.: Comparison of histological features in early spontaneous and induced trisomic abortions. Placenta 15: 765–773, 1994.PubMedCrossRefGoogle Scholar
  151. Lippman, A., Vekemans, M.J.J. and Perry, T.B.: Fetal mortality at the time of chorionic villi sampling. Hum. Genet. 68: 337–339, 1984.PubMedCrossRefGoogle Scholar
  152. Lo, Y.M.D., Patel, P., Sampietro, M., Gillmer, M.D.G., Fleming, K.A. and Wainscoat, J.S.: Detection of single-copy fetal DNA sequence from maternal blood. Lancet 335: 1463–1464, 1990.PubMedCrossRefGoogle Scholar
  153. Lo, Y.M.D., Corbetta, N., Chamberlain, RE, Rai, V., Sargent, I.L., Redman, C.W.G. and Wainscoat, J.S.: Presence of fetal DNA in maternal plasma and serum. Lancet 350: 485–487, 1997.PubMedCrossRefGoogle Scholar
  154. Luckett, W.P.: The development of the yolk sac during the first three weeks of gestation in the human and rhesus monkey. Anat. Rec. 172: 358, 1972.Google Scholar
  155. MacLean, M.A., Wilson, R., Thomson, J.A., Krishnamurthy, S. and Walker, J.J.: Changes in immunologic parameters in normal pregnancy and spontaneous abortion. Am. J. Obstet. Gynecol. 165: 890–895, 1991.PubMedGoogle Scholar
  156. Magenis, R.E.: On the origin of chromosomal anomaly. Am. J. Hum. Genet. 42: 529–533, 1988.PubMedGoogle Scholar
  157. Mallmann, P., Mallmann, R. and Krebs, D.: Determination of tumor necrosis factor alpha (TNF-alpha) and interleukin 2 (IL-2) in women with idiopathic recurrent miscarriage. Arch. Gynecol. Obstet. 249: 73–78, 1991.PubMedCrossRefGoogle Scholar
  158. Manabe, Y., Okamura, H. and Yoshida, Y.: Bougie-induced abortion at mid-pregnancy and placental function: histological and histochemical study of the placenta. Endokrinologie 57: 389–394, 1971.PubMedGoogle Scholar
  159. Marini, A., Suma, V., Baccichetti, C. and Lenzini, E.: A case of septic miscarriage, a probable complication of chorion villus sampling. Prenatal Diagn. 8: 399–400, 1988.CrossRefGoogle Scholar
  160. Matayoshi, K., Yoshida, K., Soma, H., Miyabara, S. and Okamoto, N.: Placental pathology associated with chromosomal anomalies of the human neonate: a survey of seven cases. Congenital Anom. (Jpn) 17: 507–512, 1977.Google Scholar
  161. McFadden, D.E., Pantzer, J.T. and Langlois, S.: Parental origin of triploidy—digyny, not diandry (abstract 28). Mod. Pathol. 7: 5P, 1994.Google Scholar
  162. McIntyre, J.A., Faulk, W.P., Nichols-Johnson, V.R. and Taylor, C.G.: Immunologic testing and immunotherapy in recurrent spontaneous abortion. Obstet. Gynecol. 67: 169–174, 1986.PubMedCrossRefGoogle Scholar
  163. McLean, J.M.: Early embryo loss. Lancet 1: 1033–1034, 1987.PubMedCrossRefGoogle Scholar
  164. Melius, F.A., Julian, T.M. and Nagel, T.C.: Prolonged retention of intrauterine bones. Obstet. Gynecol. 78: 919–921, 1991.PubMedGoogle Scholar
  165. Mennuti, M.T., Jingeleski, S., Schwarz, R.H. and Mellman, W.J.: An evaluation of cytogenetic analysis as a primary tool in the assessment of recurrent pregnancy wastage. Obstet. Gynecol. 52: 308–313, 1978.PubMedGoogle Scholar
  166. Michel, M., Underwood, J., Clark, D.A., Mowbray, J.F. and Beard, R.W.: Histologic and immunologic study of uterine biopsy tissue of women with incipient abortion. Am. J. Obstet. Gynecol. 161: 409–414, 1989.PubMedGoogle Scholar
  167. Miller, J.F., Williamson, E., Glue, J., Gordon, Y.B., Grudzinskas, J.G. and Sykes, A.: Fetal loss after implantation: a prospective study. Lancet 2: 554–556, 1980.PubMedCrossRefGoogle Scholar
  168. Miller, K., Metze, V., Wang, R., Lin, X. and Rehder, H.: Proliferation kinetics of chorionic villi in chromosomally normal and abnormal spontaneous abortions analyzed by premature chromosome condensation and northern blot. Ann. Genét. 39: 159–167, 1996.PubMedGoogle Scholar
  169. Mills, J.L., Simpson, J.L., Driscoll, S.G., Jovanovic-Peterson, L., van Allen, M., Aarons, J.H., Metzger, B., Bieber, ER., Knopp, R.H., Holmes, L.B., Peterson, C.M., Withiam-Wilson, M., Brown, Z., Ober, C., Harley, E., MacPherson, T.A., Duckles, A., Mueller-Heubach, E. and National Institute of Child Health: Incidence of spontaneous abortion among normal women and insulin-dependent diabetic women whose pregnancies were identified within 21 days of conception. N. Engl. J. Med. 319: 1617–1623, 1988.CrossRefGoogle Scholar
  170. Moen, D.W., Werner, J.K. and Bersu, E.T.: Analysis of gross anatomical variations in human triploidy. Am. J. Med. Genet. 18: 345–356, 1984.PubMedCrossRefGoogle Scholar
  171. Monrozies, M.: La gravité actuelle de l’avortement provoqué. Gynécol. Obstet. (Paris) 70: 79–94, 1971.Google Scholar
  172. Moon, H.S., Park, Y.H., Kwon, H.Y., Hong, S.H. and Kim, S.K.: Iatrogenic secondary infertility caused by residual intrauterine bone after midtrimester abortion. Am. J. Obstet. Gynecol. 176: 369–370, 1997.PubMedCrossRefGoogle Scholar
  173. Moore, G.E., Ali, Z., Khan, R.U., Blunt, S., Bennett, P.R. and Vaughan, J.I.: The incidence of uniparental disomy associated with intrauterine growth retardation in a cohort of thirty-five severely affected babies. Am. J. Obstet. Gynecol. 176: 294–299, 1997.PubMedCrossRefGoogle Scholar
  174. Moore, K.L.: The Developing Human: Clinically Oriented Embryology. 3rd Ed. Saunders, Philadelphia, 1982.Google Scholar
  175. Moore, K.L., Persaud, T.V.N. and Shiota, K.: Color Atlas of Clinical Embryology. Saunders, Philadelphia, 1994.Google Scholar
  176. Mostello, D.J., Bofinger, M.K. and Siddiqi, T.A.: Spontaneous resolution of fetal cystic hygroma and hydrops in Turner syndrome. Obstet. Gynecol. 73: 862–865, 1989.PubMedGoogle Scholar
  177. Mowbray, J.F., Gibbings, C., Liddell, H., Reginald, P.W., Underwood, J.L. and Beard, R.W.: Controlled trial of treatment of recurrent spontaneous abortion by immunisation with paternal cells. Lancet 1: 941–944, 1985.PubMedCrossRefGoogle Scholar
  178. Mueller-Eckhardt, G., Heine, O. and Polten, B.: IVIG to prevent recurrent spontaneous abortion. Lancet 337: 424–425, 1991.PubMedCrossRefGoogle Scholar
  179. Muggah, H.F., D’Alton, M.E. and Hunter, A.G.W.: Chorionic villus sampling followed by genetic amniocentesis and septic shock. Lancet 1: 867–868, 1987.PubMedCrossRefGoogle Scholar
  180. Neu, R.L., Entes, K. and Bannerman, R.M.: Chromosome analysis in cases with repeated spontaneous abortions. Obstet. Gynecol. 53: 373–375, 1979.PubMedGoogle Scholar
  181. Neuber, M., Rehder, H., Zuther, C., Lettau, R. and Schwinger, E.: Polyploidies in abortion material decreases with maternal age. Hum. Genet. 41: 563–566, 1993.Google Scholar
  182. Nishimura, H., Takano, K., Tanimura, T. and Yasuda, M.: Normal and abnormal development of human embryos: first report of the analysis of 1,213 intact embryos. Teratology 1: 281–290, 1968.PubMedCrossRefGoogle Scholar
  183. Novak, R., Agamanolis, D., Dasu, S., Igel, H., Platt, M., Robinson, H. and Shehata, B.: Histologic analysis of placental tissue in first trimester abortions. Pediatr. Pathol. 8: 477–482, 1988.PubMedCrossRefGoogle Scholar
  184. Olding, L., Benirschke, K. and Oldstone, MBA Inhibition of mitosis of lymphocytes from human adults by lymphocytes from newborns. Clin. Immun. Immunopathol. 3: 79–89, 1974.CrossRefGoogle Scholar
  185. Olney, R.S., Khoury, M.J., Alo, C.J., Costa, P., Edmonds, L.D., Flood, T.J., Harris, J.A., Howe, H.L., Moore, C.A., Olsen, C.L., Panny, S.R. and Shaw, G.M.: Increased risk for transverse digital deficiency after chorionic villus sampling: results of the United States multistate case-control study, 1988–1992. Teratology 51: 20–29, 1995.PubMedCrossRefGoogle Scholar
  186. Ornoy, A., Kohn, G., Zur, Z.B., Weinstein, D. and Cohen, M.M.: Triploidy in human abortions. Teratology 18: 315–320, 1978.PubMedCrossRefGoogle Scholar
  187. Ornoy, A., Salamon-Arnon, J., Ben-Zur, Z. and Kohn, G.: Placental findings in spontaneous abortions and stillbirths. Teratology 24: 243–252, 1981.PubMedCrossRefGoogle Scholar
  188. Palomaki, J.F. and Little, A.B.: Surgical management of abortion. N. Engl. J. Med. 287: 752–754, 1972.PubMedCrossRefGoogle Scholar
  189. Parazzini, E, Acacia, B., Faden, D., Lovotti, M., Marelli, G. and Cortelazzo, S.: Antiphospholipid antibodies and recurrent abortion. Obstet. Gynecol. 77: 854–858, 1991.PubMedGoogle Scholar
  190. Philippe, E.: Pathologie Foeto-Placentaire. Masson, Paris, 1986.Google Scholar
  191. Philippe, E. and Boué, E.: Le placenta des aberrations chromosomiques foétales. Ann. Anat. Pathol. (Paris) 14: 249–266, 1969.Google Scholar
  192. Phillips. O.W., Tharapel, A.T., Lerner, J.L., Park, V.M., Wachtel, S.S. and Shulman, L.P.: Risk of fetal mosaicism when placental mosaicism is diagnosed by chorionic villus sampling. Am. J. Obstet. Gynecol. 174: 850–855, 1996.CrossRefGoogle Scholar
  193. Plouffe, L., White, E.W., Tho, S.P., Sweet, C.S., Layman, L.C., Whitman, G.F. and McDonough, P.G.: Etiologic factors of recurrent abortion and subsequent reproductive performance of couples: have we made any progress in the past 10 years ? Am. J. Obstet. Gynecol. 167: 313–321, 1992.PubMedGoogle Scholar
  194. Portnoi, M.-E, Joye, N., van den Akker, J., Morlier, G. and Taillemite, J.-L.: Karyotypes of 1,142 couples with recurrent abortion. Obstet. Gynecol. 72: 31–34, 1988.PubMedGoogle Scholar
  195. Pozniak, M.A., Cullenward, M.J., Zickuhr, D. and Curet, L.B.: Venous lake bleeding: a complication of chorionic villous sampling. J. Ultrasound Med. 7: 297–299, 1988.PubMedGoogle Scholar
  196. Pridjian, G. and Moawad, A.H.: Missed abortion: still appropriate terminology ? Am. J. Obstet. Gynecol. 161: 261–262, 1989.PubMedGoogle Scholar
  197. Quintero, R.A., Romero, R., Mahoney, M.J., Abuhamad, A., Vecchio, M., Holden, J. and Hobbins, J.C.: Embryoscopic demonstration of hemorrhagic lesions on the human embryo after placental trauma. Am. J. Obstet. Gynecol. 168: 756–759, 1993.PubMedGoogle Scholar
  198. Qureshi, E, Jacques, S.M., Johnson, M.P. and Evans, M.I.: Histopathologic and growth characteristics of trisomy 21 placentas (abstract 40). Mod. Pathol. 7: 7P, 1994.Google Scholar
  199. Rai, R. and Regan, L.: Antiphospholipid antibodies in women undergoing in-vitro fertilization. Hum. Reprod. (Oxf.) 12: 197–199, 1997.CrossRefGoogle Scholar
  200. Redline, R.W., Hassold, T. and Zaragoza, M.: Determinants of villous trophoblastic hyperplasia in spontaneous abortions. Mod. Pathol. 11: 762–768, 1998.PubMedGoogle Scholar
  201. Rehder, H. and Gropp, A.: Triploidie als Ursache fötoplacentarer Fehlbildung bei Abortus. Verh. Dtsch. Ges. Pathol. 55: 525–529, 1971.PubMedGoogle Scholar
  202. Rehder, H., Coerdt, W., Eggers, R., Klink, E and Schwinger, E.: Is there a correlation between morphological and cytogenetic findings in placental tissue from early missed abortions? Hum. Genet. 82: 377–385. 1989.Google Scholar
  203. Reid, T.M.S.: Striking a balance in maternal immune response to infection. Lancet 351: 1670–1672, 1998.PubMedCrossRefGoogle Scholar
  204. Rhoads, G.G., Jackson, L.G., Schiesselman, S.E., de la Cruz, F.F., Desnick, R.J., Golbus, M.S., Ledbetter, D.H., Lubs, H.A., Mahoney, M.J., Pergament, E., Simpson. J.L., Carpenter, R.J., Elias, S., Ginsberg, N.A., Goldberg, J.D., Hobbins, J.C., Lynch, L., Shiono, EH., Wapner, R.J. and Zachary, J.M.: The safety and efficacy of chorionic villus sampling for early prenatal diagnosis of cytogenetic abnormalities. N. Engl. J. Med. 320: 609–617, 1989.Google Scholar
  205. Rochelson, B., Kaplan, C., Guzman, E., Arato, M., Hansen, K. and Trunca, C.: A quantitative analysis of placental vasculature in the third-trimester fetus with autosomal trisomy. Obstet. Gynecol. 75: 59–63, 1990.PubMedGoogle Scholar
  206. Rosenbusch, B., Schneider, M. and Sterzik, K.: Triploidy caused by endoreduplication in a human zygote obtained after in-vitro fertilization. Hum. Reprod. (Oxf.) 12: 1059–1061, 1997.CrossRefGoogle Scholar
  207. Rosenmann, A., Palti, Z., Segal, S. and Cohen, M.M.: Chromosomes in familial primary sterility and in couples with recurrent abortions and stillbirths. Isr. J. Med. Sci. 13: 1131–1133, 1977.PubMedGoogle Scholar
  208. Sachs, E.S., Jahoda, M.G.J., van Hemel, J.O., Hoogeboom, A.J.M. and Sandkuyl, L.A.: Chromosome studies of 500 couples with two or more abortions. Obstet. Gynecol. 65: 375–378, 1985.PubMedGoogle Scholar
  209. Sadovsky, A. and Laufer, A.: Placental changes in early spontaneous abortion. Obstet. Gynecol. 17: 678–683, 1961.PubMedGoogle Scholar
  210. Salafia, C.M. and Burns, J.P.: The correlation of placental and decidual histology with karyotype and fetal viability. Teratology 39: 478 (P37), 1989.Google Scholar
  211. Salafia, C., Maier, D., Vogel, C., Pezzullo, J., Burns, J. and Silberman, L.: Placental and decidual histology in spontaneous abortion: detailed description and correlations with chromosome number. Obstet. Gynecol. 82: 295–303, 1993.PubMedGoogle Scholar
  212. Saller, D.N., Keene, C.L., Sun, C.-C.J. and Schwartz, S.: The association of single umbilical artery with cytogenetically abnormal pregnancies. Am. J. Obstet. Gynecol. 163: 922–925, 1990.PubMedGoogle Scholar
  213. Sasaki, M., Makino, S., Muramoto, J.-I., Ikeuchi, T. and Shimba, H.: A chromosome survey of induced abortuses in a Japanese population. Chromosoma (Berl.) 20: 267–283, 1967.CrossRefGoogle Scholar
  214. Schaaps, J.P. and Hustin, J.: In vivo aspect of the maternaltrophoblastic border during the first trimester of gestation. Trophoblast Res. 3: 39–48, 1988.Google Scholar
  215. Schulman, H., Kaiser, I.H. and Randolph, G.: Outpatient saline abortion. Obstet. Gynecol. 37: 521–526, 1971.PubMedGoogle Scholar
  216. Schulze, B., Schlesinger, C. and Miller, K.: Chromosomal mosaicism confined to chorionic tissue. Prenatal Diagn. 7: 451–453, 1987.CrossRefGoogle Scholar
  217. Scott, J.R., Rote, N.S. and Branch, D.W.: Immunologic aspects of recurrent abortion and fetal death. Obstet. Gynecol. 70: 645–656, 1987.PubMedGoogle Scholar
  218. Scott, R.: Limb abnormalities after chorionic villus sampling. Lancet 337: 1038–1039, 1991.PubMedCrossRefGoogle Scholar
  219. Segal, S., Ornoy, A., Bercovici, B., Antebi, S.O. and Polishuk, W.Z.: Placental pathology in midtrimester pregnancies interrupted by intra-amniotic injection of hypertonic urea. Br. J. Obstet. Gynaecol. 83: 156–159, 1976.PubMedCrossRefGoogle Scholar
  220. Sehgal, N., Parr, M. and Haslett, E.: Clostridium infection after intra-amniotic hypertonic saline injection for induced abortion. J. Reprod. Med. 8: 67–69, 1972.PubMedGoogle Scholar
  221. Sekizawa, A., Watanabe, A., Kimura, T., Saito, H., Yanaihara, T. and Sato, T.: Prenatal diagnosis of the fetal RhD blood type using a single fetal nucleated erythrocyte from maternal blood. Obstet. Gynecol. 87: 501–505, 1996.PubMedCrossRefGoogle Scholar
  222. Seward, P.N., Ballard, C.A. and Ulene, A.L.: The effect of legal abortion on the rate of septic abortion at a large county hospital. Am. J. Obstet. Gynecol. 115: 335–338, 1973.PubMedGoogle Scholar
  223. Shaarawy, M. and Nagui, A.R.: Enhanced expression of cytokines may play a fundamental role in the mechanisms of immunologically mediated recurrent spontaneous abortion. Acta Obstet. Gynecol. Scand. 76: 205–211, 1997.Google Scholar
  224. Shaffer, L.G., McCaskill, C., Adkins, K. and Hassold, T.J. Systematic search for uniparental disomy in early fetal losses: the results and a review of the literature. Am. J. Med. Genet. 79: 366–372, 1998.PubMedCrossRefGoogle Scholar
  225. Shepard, T.H., Fantel, A.G. and Fitzsimmons, I: Congenital defect rates among spontaneous abortuses: twenty years of monitoring. Teratology 39: 325–331, 1989a.PubMedCrossRefGoogle Scholar
  226. Shepard, T.H., Fitzsimmons, J.M., Fantel, A.G. and Pascoe-Mason, J.: Placental weights of normal and aneuploid early human fetuses. Teratology 39: 481 (P54), 1989b.Google Scholar
  227. Shepard, T.H., Fitzsimmons, J.M., Fantel, A.G. and Pascoe-Mason, J.: Placental weights of normal and aneuploid early human fetuses. Pediatr. Pathol. 9: 425–431, 1989c.PubMedCrossRefGoogle Scholar
  228. Sherard, J., Bean, C., Bove, B., DelDuca, V., Esterly, K.L., Karcsh, H.J., Munshi, G., Reamer, J.F., Suazo, G., Wilmoth, D., Dahlke, M.B., Weiss, C. and Borgaonkar, S.: Long survival in a 69,XXY triploid male. Am. J. Med. Genet. 25: 307–312, 1986.PubMedCrossRefGoogle Scholar
  229. Shettles, L.: The great preponderance of human males conceived. Am. J. Obstet. Gynecol. 89: 130–133, 1964.PubMedGoogle Scholar
  230. Shivashankar, L., Whitney, E., Colmorgen, G., Young, T., Munshi, G., Wilmoth, D., Byrne, K., Reeves, G., Borgoankar, D.S., Picciano, S.R. and Martin-Deleon, P.A.: Prenatal diagnosis of tetrasomy 47,XY, + i(12p) confirmed by in situ hybridization. Prenatal Diagn. 8: 85–91, 1988.CrossRefGoogle Scholar
  231. Shulman, L.P., Meyers, C.M., Simpson, J.L., Andersen, R.N., Tolley, E.A. and Elias, S.: Fetomaternal transfusion depends on amount of chorionic villi aspirated but not on method of chorionic villus sampling. Am. J. Obstet. Gynecol. 162: 1185–1188, 1990.PubMedGoogle Scholar
  232. Simpson, J.L., Meyers, C.M., Martin, A.O., Elias, S. and Ober, C.: Translocations are infrequent among couples having repeated spontaneous abortions but no other abnormal pregnancies. Fertil. Steril. 51: 811–814, 1989.PubMedGoogle Scholar
  233. Simpson, J.L, and Elias, S.: Fetal cells in maternal blood. Ann. N.Y. Acad. Sci. 731: 1–270, 1994.PubMedCrossRefGoogle Scholar
  234. Singh, R.P. and Carr, D.H.: Anatomic findings in human abortions of known chromosomal constitution. Obstet. Gynecol. 29:806–818,1967Google Scholar
  235. Singh, R.P. and Carr, D.H.: Congenital anomalies in embryos with normal chromosomes. Biol. Neonate 13: 121–128, 1968.CrossRefGoogle Scholar
  236. Smid, M., Lagona, F., Papasergio, N., Ferrari, A., Ferrari, M. and Cremonesi, L.: Influence of gestational age on fetal deoxyri-bonucleic acid retrieval in maternal peripheral blood. Am. J. Obstet. Gynecol. 177: 1517–1522, 1997.PubMedCrossRefGoogle Scholar
  237. Smith, A. and Gaha, T.J.: Data on families of chromosome translocation carriers ascertained because of habitual abortion. Aust. N.Z. J. Obstet. Gynaecol. 30: 57–62, 1990.PubMedCrossRefGoogle Scholar
  238. Smith, S.C., Baker, P.N. and Symonds, E.M.: Placental apoptosis in normal human pregnancy. Am. J. Obstet. Gynecol. 177: 57–65, 1997a.PubMedCrossRefGoogle Scholar
  239. Smith, S.C., Baker, P.N. and Symonds, E.M.: Increased placental apoptosis in intrauterine growth restriction. Am. J. Obstet. Gynecol. 177: 1395–1401, 1997b.PubMedCrossRefGoogle Scholar
  240. Steier, J.A., Sandvei, R. and Myking, O.L.: Human chorionic gonadotropin in early normal and pathological pregnancy: discordant levels in peripheral maternal blood and blood from the uterine and abdominal cavities. Am. J. Obstet. Gynecol. 154: 1091–1094, 1986.PubMedGoogle Scholar
  241. Stein, Z.A.: A woman’s age: childbearing and child rearing. Am. J. Epidemiol. 121: 327–342, 1985.PubMedGoogle Scholar
  242. Steinberg, C.R., Berkowitz, R.L., Merkatz, I.R. and Roberts, R.B.: Fever and bacteremia associated with hypertonic saline abortion. Obstet. Gynecol. 39: 673–678, 1972.PubMedGoogle Scholar
  243. Stern, J.J. and Coulam, C.B.: Mechanism of recurrent spontaneous abortion. I. Ultrasonographic findings. Am. J. Obstet. Gynecol. 166: 1844–1852, 1992.Google Scholar
  244. Stewart, G.K. and Goldstein, P.J.: Therapeutic abortion in California. Effects on septic abortion and maternal mortality. Obstet. Gynecol. 37: 510–514, 1971.PubMedGoogle Scholar
  245. Stioui, S., de Silvestris, M., Molinari, A., Stripparo, L., Ghisoni, L. and Simoni, G.: Trisomic 22 placenta in a case of severe intrauterine growth retardation. Prenatal Diagn. 9: 673–676, 1989.CrossRefGoogle Scholar
  246. Stirrat, G.M.: Recurrent miscarriage I: definition and epidemiology. Lancet 336: 673–675, 1990a.PubMedCrossRefGoogle Scholar
  247. Stirrat, G.M.: Recurrent miscarriage II: clinical associations, causes, and management. Lancet 336: 728–733, 1990b.PubMedCrossRefGoogle Scholar
  248. Strom, C.M., Rechitsky, S., Ginsberg, N., Verlinsky, O. and Verlinsky, Y.: Prenatal paternity testing with deoxyribonucleic acid technique. Am. J. Obstet. Gynecol. 174: 1849–1854, 1996.PubMedCrossRefGoogle Scholar
  249. Studdiford, W.E. and Douglas, G.W.: Placental bacteremia: a significant finding in septic abortion accompanied by vascular collapse. Am. J. Obstet. Gynecol. 71: 842–858, 1956.PubMedGoogle Scholar
  250. Sundberg, K. and Smidt-Jensen, S.: Non-mosaic trisomy 16 on chorionic villus sampling but normal placenta and fetus after termination. Lancet 337: 1233–1234, 1991.PubMedCrossRefGoogle Scholar
  251. Suter, P.E.N., Chatfield, W.R. and Kotonya, A.O.: The use of suction curettage in incomplete abortion. J. Obstet. Gynaecol. Br. Commonw. 77: 464–466, 1970.PubMedCrossRefGoogle Scholar
  252. Suzumori, K., Adachi, R., Okada, S., Narukawa, T., Yagami, Y. and Sonta, S.: Fetal cells in the maternal circulation: detection of Y-sequence by gene amplification. Obstet. Gynecol. 80: 150–154, 1992.PubMedGoogle Scholar
  253. Takabayashi, H., Kuwabara, S., Ukita, T., Ikawa, K., Yamafuji, K. and Igarashi, T.: Development of non-invasive fetal DNA diagnosis from maternal blood. Prenatal Diagn. 15: 74–77, 1995.CrossRefGoogle Scholar
  254. Tal, J., Timor-Tritsch, I. and Degani, S.: Accurate diagnosis of postabortal placental remnant by sonohysterography and color Doppler sonographic studies. Gynecol. Obstet. Invest. 43: 131–134, 1997.PubMedCrossRefGoogle Scholar
  255. Tharapel, A.T., Elias, S., Shulman, L.P., Seely, L., Emerson, D.S. and Simpson, J.L.: Resorbed co-twin as an explanation for discrepant chorionic villus results: non-mosaic 47,XX, + 16 in villi (direct and culture) with normal (46,XX) amniotic fluid and neonatal blood. Prenatal Diagn. 9: 467–472, 1989.CrossRefGoogle Scholar
  256. Thiet, M.P., Suwanvanichkij, V., Kwok, C. and Yeh, J.: DNA laddering, consistent with programmed cell death, is a normal finding in human placentas (abstract 47). Am. J. Obstet. Gynecol. 172: 272, 1995.Google Scholar
  257. Turleau, C., Chavin-Colin, F. and de Grouchy, J.: Cytogenetic investigation in 413 couples with spontaneous abortions. Eur. J. Obstet. Gynecol. Reprod. Biol. 9: 65–74, 1979.PubMedCrossRefGoogle Scholar
  258. Tycko, B.: Genomic imprinting: mechanism and role in human pathology. Am. J. Pathol. 144: 431–443, 1994.PubMedGoogle Scholar
  259. Verjaal, M., Leschot, N.J., Wolf, H. and Treffers, RE.: Karyotypic differences between cells from placenta and other fetal tissues. Prenatal Diagn. 7: 343–348, 1987.CrossRefGoogle Scholar
  260. Vernof, K.K., Ney, J.A. and Dewald, G.W.: Pure placental trisomy 16 associated with a 46,XY infant and severe preeclampsia: a case report (abstract). Am. J. Obstet. Gynecol. 166: 434, 1992.Google Scholar
  261. Verp, M.S., Rosinsky, B., Sheikh, Z. and Amarose, A.P.: Non-mosaic trisomy 16 confined to villi. Lancet 2: 915–916, 1989.PubMedCrossRefGoogle Scholar
  262. Vincent, T., Rai, R., Regan, L. and Cohen, H.: Increased thrombin generation in women with recurrent miscarriage. Lancet 352: 116, 1998.PubMedCrossRefGoogle Scholar
  263. Vogel, M.: Placentabefunde beim Abort: ein Beitrag zur PathoMorphologie placentarer Entwicklungsstörungen. Virchows Arch. A 346: 212–223, 1969.CrossRefGoogle Scholar
  264. Vogel, M.: Atlas der Morphologischen Plazentadiagnostik. Springer-Verlag, Berlin, 1992.CrossRefGoogle Scholar
  265. Wade, R.V. and Young, S.R.: Analysis of fetal loss after trans-cervical chorionic villus sampling—a review of 719 patients. Am. J. Obstet. Gynecol. 161: 513–519, 1989.PubMedGoogle Scholar
  266. Wall, R.L. and Hertig, A.T.: Habitual abortion. Am. J. Obstet. Gynecol. 56: 1127–1133, 1948.PubMedGoogle Scholar
  267. Ward, B.E., Henry, G.P. and Robinson, A.: Cytogenetic studies in 100 couples with recurrent spontaneous abortions. Am. J. Hum. Genet. 32: 549–554, 1980.PubMedGoogle Scholar
  268. Wegmann, T.G., Gill, T.J., Cumming, C.D. and Nisbet-Brown, E., eds.: Immunology of Reproduction. Oxford University Press, New York, 1983.Google Scholar
  269. Wenstrom, K.D., Owen, J., Chu, D.C. and Boots, L.: afetoprotein, free 13-human chorionic gonadotropin, and dimeric inhibin A produce the best results in a three-analyte, multiple marker screening test for fetal Down syndrome. Am. J. Obstet. Gynecol. 177: 987–991, 1997.PubMedCrossRefGoogle Scholar
  270. van Wijk, I.J., van Vugt, J.M.G., Mulders, M.A.M., Könst, A.A.M., Weima, S.M. and Oudemjans, C.B.M.: Enrichment of fetal trophoblast cells from maternal peripheral blood followed by detection of fetal deoxyribonucleic acid with a nested X/Y polymerase chain reaction. Am. J. Obstet. Gynecol. 174: 871–876, 1996.PubMedCrossRefGoogle Scholar
  271. Wilcox, A.J., Weinberg, C.R., O’Connor, J.F., Baird, D.D., Schlatterer, J.P., Canfield, R.E., Armstrong, E.G. and Nisula, B.C.: Incidence of early loss of pregnancy. N. Engl. J. Med. 319: 189–194, 1988.PubMedCrossRefGoogle Scholar
  272. Wilkins-Haug, L., Roberts, D.J. and Morton, C.C.: Confined placental mosaicism and intrauterine growth retardation: a case-control analysis of placentas at delivery. Am. J. Obstet. Gynecol. 172: 44–50, 1995.PubMedCrossRefGoogle Scholar
  273. Williams, J., Wang, B.T., Rubin, C.H. and Aiken-Hunting, D.: Chorionic villus sampling: experience with 3,016 cases performed by a single operator. Obstet. Gynecol. 80: 1023–1029, 1992.PubMedGoogle Scholar
  274. Wolf, G.C. and Horger, E.O.: Indications for examination of spontaneous abortion: a reassessment. Am. J. Obstet. Gynecol. 173: 1364–1368, 1995.PubMedCrossRefGoogle Scholar
  275. Yamamoto, M. and Watanabe, G.: Epidemiology of gross chromosomal anomalies at early embryonic stage of pregnancy. Contrib. Epidemiol. Biostat. 1: 101–106, 1979.Google Scholar
  276. Yokoyama, W.M.: The mother-child union: the case of missing-self and protection of the fetus. Proc. Natl. Acad. Sci. U.S.A. 94: 5998–6000, 1997.PubMedCrossRefGoogle Scholar
  277. Younis, J.S.: Factor V Leiden—a novel etiology of the longstanding thrombosis theory for recurrent pregnancy loss. Am. J. Obstet. Gynecol. 178: 1107–1108, 1998.PubMedCrossRefGoogle Scholar
  278. Zerres, K., Niesen, M., Schwanitz, G. and Hansmann, M.: Trisomie 22—Pränatale Befunde unterschiedlicher Entwicklungsstadien. Geburtsh. Frauenheilkds 48: 720–723, 1988.CrossRefGoogle Scholar
  279. Zuccotti, M. and Monk, M.: The mouse xist gene: a model for studying the gametic imprinting phenomenon. Acta Genet. Med. Gemellol. 45: 199–204, 1996.Google Scholar

Copyright information

© Springer Science+Business Media New York 2000

Authors and Affiliations

  • Kurt Benirschke
    • 1
  • Peter Kaufmann
    • 2
  1. 1.University Medical CenterUniversity of California, San DiegoSan DiegoUSA
  2. 2.Institut für Anatomie der Medizinischen FakultätRheinisch-Westfälische Technische Hochschule AachenAachenGermany

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