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

  • Kurt Benirschke
  • Peter Kaufmann


For the present discussions, 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 during 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 either with an embryo (that may be treated as a surgical specimen) or 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 instance, Vogel (1969, 1992) considered an abortion an expelled fetus of less than 1,000g. He differentiated between embryonic and fetal (15–28 weeks) abortion. Legal viability is frequently considered to be attained only at 28 weeks’ 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 in context with current terminology the studies of Vogel (1969, 1992). Most spontaneous abortions occur before 12 weeks’ gestation, and most are due to chromosomal errors in the conceptus. Relatively few truly spontaneous abortions take place between 12 and 20 weeks’ gestation. Thereafter, between 20 and 30 weeks, another type of premature spontaneous termination becomes prevalent—that due to ascending infection. These are fundamentally different processes with vastly different pathological findings.


Spontaneous Abortion Hypertonic Saline Hydatidiform Mole Legal Abortion Chorionic Villus Sampling 
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.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Abaci, F., 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 paracervical 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 mid-trimester termination. Obstet. Gynecol. 53: 583–586, 1979.PubMedGoogle Scholar
  10. 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
  11. Barela, A.I., Kleinman, G.E., Golditch, I.M., Menke, D.J., Rogge, 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
  12. Beer, A.E., and Billingham, R.E.: The Immunobiology of Mammalian Reproduction. Prentice Hall, Englewood Cliffs, NJ, 1976.Google Scholar
  13. 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
  14. 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. Prenat. Diagn. 8: 471–474, 1988.PubMedCrossRefGoogle Scholar
  15. Bogart, M.H., Pandian, M.R., and Jones, O.W.: Abnormal maternal serum chorionic gonadotropin levels in pregnancies with fetal chromosome abnormalities. Prenat. Diagn. 7: 623–630, 1987.PubMedCrossRefGoogle Scholar
  16. Bogart, M.H., Golbus, M.S., Sorg, N.D., and Jones, O.W.: Human chorionic gonadotropin levels in pregnancies with aneuploid fetuses. Prenat. Diagn. 9: 379–384, 1989.PubMedCrossRefGoogle Scholar
  17. 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
  18. 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
  19. Brambati, B., and Varotto, F.: Infection and chorionic villus sampling. Lancet 2: 609, 1985.CrossRefGoogle Scholar
  20. 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. Prenat. Diagn. 6: 375–377, 1986.PubMedCrossRefGoogle Scholar
  21. 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.PubMedGoogle Scholar
  22. 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
  23. 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
  24. Carr, D.H.: Chromosomal studies in spontaneous abortions. Obstet. Gynecol. 26: 308–326, 1965.PubMedGoogle Scholar
  25. 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
  26. Castle, D., and Bernstein, R.: Cytogenetic analysis of 688 couples experiencing multiple spontaneous abortions. Am. J. Med. Genet. 29: 549–556, 1988.PubMedCrossRefGoogle Scholar
  27. 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
  28. 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
  29. 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
  30. 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
  31. 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
  32. 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
  33. 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
  34. 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
  35. DeLozier-Blanchet, C., Francipane, L., Ebener, J., Cox, J., and Extermann, P.: Cytogenetic discrepancies between fetus and placenta: a frequent cause of reproductive pathologies? [abstract A.14]. Placenta 14: A14, 1993.CrossRefGoogle Scholar
  36. Dickey, R.P., Olar, T.T., Taylor, S.N., Curole, D.N., and Matulich, E.M.: Relationship of small gestational saccrown-rump length differences to abortion and abortus karyotypes. Obstet. Gynecol. 79: 554–557, 1992.PubMedGoogle Scholar
  37. Eckman, T.R., and Carrow, L.A.: Placental lesions in spontaneous abortion. Am. J. Obstet. Gynecol. 84: 222–228, 1962.PubMedGoogle Scholar
  38. Edwards, R.G., Howe, C.W.S., and Johnson, M.H.: Immunobiology of Trophoblast. Cambridge University Press, Cambridge, 1975.Google Scholar
  39. 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
  40. Elias, S., Price, J., Dockter, M., Wachtel, S., Tharapel, A., Simpson, J.L., and Klinger, K.W.: First trimester prenatal diagnosis of trisomy 21 in fetal cells from maternal blood. Lancet 340: 1033, 1992.PubMedCrossRefGoogle Scholar
  41. Eroglu, G., Betz, G., and Torregano, C.: Impact of histocompatibility antigens on pregnancy outcome. Am. J. Obstet. Gynecol. 166: 1364, 1369, 1992.Google Scholar
  42. Firth, H.V., Boyd, P.A., Chamberlain, P., 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, 1991.PubMedCrossRefGoogle Scholar
  43. Fox, H.: Histological classification of tissue from spontaneous abortions: a valueless exercise? Histopathology 22: 599–600, 1993.PubMedCrossRefGoogle Scholar
  44. 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
  45. Frigoletto, F.D., and Pokoly, T.B.: Electrolyte dynamics in hypertonic saline-induced abortions. Obstet. Gynecol. 38: 647–652, 1971.PubMedGoogle Scholar
  46. 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
  47. 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
  48. 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
  49. Gänshirt-Ahlert, D., Burschyk, M., Garritsen, H.S.P., Helmer, L., Miny, P., 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
  50. 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, CT, 1989.Google Scholar
  51. Geisler, M., and Gropp, A.: Zur Methode der Züchtung von Abortmaterial für Chromosomenuntersuchungen (Zugleich Mitteilung über die Beobachtung einer B-Trisomie bei Abortus). Geburtshilfe Frauenheilkd. 27: 113–126, 1967.PubMedGoogle Scholar
  52. Geisler, M., Kleinebrecht, J., and Degenhardt, K.-H.: Histologische Analysen von triploiden Spontanaborten. Humangenetik 16: 283–294, 1972.PubMedGoogle Scholar
  53. Gill, T.J., Wegmann, T.G., and Nisbet-Brown, E.: Immunoregulation and Fetal Survival. Oxford University Press, New York, 1987.Google Scholar
  54. Göcke, H., Schwanitz, G., Muradow, I., and Zerres, K.: Pathomorphologie und Genetik in der Frühschwangerschaft. Pathologe 6: 249–259, 1985.PubMedGoogle Scholar
  55. 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
  56. 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
  57. 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
  58. 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
  59. Harrison, R.G., Jones, C.H., and Jones, E.P.: A pathological presomite human embryo. J. Pathol. Bacteriol. 92: 583–584, 1966.PubMedCrossRefGoogle Scholar
  60. Hassold, T., Chen, N., Funkhouser, J., Jooss, T., Manuel, B., Matsuura, J., Matsuyama, A., Wilson, C., Yamana, J.A., and Jacobs, P.A.: A cytogenetic study of 1,000 spontaneous abortions. Ann. Hum. Genet. 44: 151–178, 1980.PubMedCrossRefGoogle Scholar
  61. 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
  62. Hecht, F.: The placenta in trisomy 18 syndrome: report of 2 cases. Obstet. Gynecol. 22: 147–148, 1963.PubMedGoogle Scholar
  63. Henderson, D.J., Bennett, P.R., 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
  64. Herbst, R., and Multier, A.-M.: Structures pathologiques du placenta examinées au microscope électronique: premiéres observations des villosités de l’oef abortif humain. Gynecol. Obstet. (Paris) 70: 369–376, 1971.Google Scholar
  65. 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
  66. Hem, W.M.: Correlation of fetal age and measurements between 10 and 26 weeks of gestation. Obstet. Gynecol. 63: 26–32, 1984.Google Scholar
  67. 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
  68. 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
  69. Hertz-Picciotto, I., and Samuels, S.J.: Incidence of early loss of pregnancy. N. Engl. J. Med. 319: 1483–1484, 1988.PubMedCrossRefGoogle Scholar
  70. 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. Gäynecol. 166: 1044–1052, 1992.Google Scholar
  71. 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
  72. 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
  73. 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.PubMedCrossRefGoogle Scholar
  74. Honoré, L.H., Lin, C.C., and Bamforth, J.S.: Spontaneous abortion with uncommon Five cases of trisomy 15 in first trimester spontaneous abortion: gross and microscopic pathology [abstract P421. Teratology 37: 458–459, 1989.Google Scholar
  75. 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
  76. 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
  77. Huber, C.P., Melin, J.R., and Vellios, F.: Changes in chorionic tissue of aborted pregnancy. Am. J. Obstet. Gynecol. 73: 569–578, 1957.PubMedGoogle Scholar
  78. 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
  79. 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
  80. Human triploidy: relationship between parental origin of the additional haploid complement and development of partial hydatidiform mole. Ann. Hum. Genet. 46:223–231, 1982.Google Scholar
  81. 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
  82. Jewett, J.F.: Two deaths from mid-trimester abortion. N. Engl. J. Med. 288: 47–48, 1973.PubMedCrossRefGoogle Scholar
  83. 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
  84. 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
  85. Jurkovic, I., and Muzelak, R.: Frequency of pathologic changes in the young cases studied histologically. Am. J. Obstet. Gynecol. 108: 382–386, 1970.PubMedGoogle Scholar
  86. Jurukovski, J.N.: Complications following legal abortions. Proc. R. Soc. Med. 62: 830–831, 1969.PubMedGoogle Scholar
  87. Kaali, S.G., Szigetvari, I.A., and Bartfai, G.S.: The frequency and management of uterine perforations duringGoogle Scholar
  88. first-trimester abortions. Am. J. Obstet. Gynecol. 161: 406–408, 1989.Google Scholar
  89. 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
  90. 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
  91. 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
  92. Kalousek, D.K.: Anatomic and chromosome anomalies in specimens of early spontaneous abortion: 7 year experience. Birth Defects 23: 153–168, 1987.PubMedGoogle Scholar
  93. Kalousek, D.K., and Barrett, I.: Confined placental mosaicism and stillbirth. Pediatr. Pathol. 14: 151–159, 1994.PubMedCrossRefGoogle Scholar
  94. Kalousek, D.K., and Dill, F.J.: Chromosomal mosaicism confined to the placenta in human conceptions. Science 221: 665–667, 1983.PubMedCrossRefGoogle Scholar
  95. 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
  96. 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
  97. 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
  98. 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
  99. Kazy, Z., Rozovsky, I.S., and Bakharev, V.A.: Chorion biopsy in early pregnancy: a method for early prenatal diagnosis for inherited disorders. Prenat. Diagn. 2: 39–45, 1982.CrossRefGoogle Scholar
  100. Kellokumpu-Lehtinen, P., and Pelliniemi, L.J.: Sex ratio of human conceptuses. Obstet. Gynecol. 64: 220–222, 1984.PubMedGoogle Scholar
  101. 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
  102. Knoth, M., and Larsen, J.F.: Ultrastructure of a human implantation site. Acta Obstet. Gynecol. Scand. 51: 385393, 1972.Google Scholar
  103. Kouvalainen, K., and Österlund, K.: Placental weights in Down’s syndrome. Ann. Med. Exp. Fenn. 45: 320–322, 1967.PubMedGoogle Scholar
  104. 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
  105. 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
  106. 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
  107. 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
  108. 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
  109. 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
  110. Kuliev, A.M.: Cytogenetic investigation of spontaneous abortions. Humangenetik 12: 275–283, 1971.PubMedCrossRefGoogle Scholar
  111. 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
  112. 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
  113. Ladefoged, C.: Hydrop degeneration: a histopathological investigation of 260 early abortions. Acta Obstet. Gynecol. Scand. 59: 509–512, 1980.CrossRefGoogle Scholar
  114. 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. Gynecol. 162: 986–990, 1990.PubMedGoogle Scholar
  115. Letters to the editor: Lancet 337: 1091–1092, 1991.CrossRefGoogle Scholar
  116. Letters to the Editor: Antiphospholipid antibodies and fetal loss. N. Engl. J. Med. 326:951–954, 1992.Google Scholar
  117. 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
  118. 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: 284288, 1988.Google Scholar
  119. 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
  120. 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
  121. 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
  122. Macean, 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.Google Scholar
  123. Magenis, R.E.: On the origin of chromosomal anomaly. Am. J. Hum. Genet. 42: 529–533, 1988.PubMedGoogle Scholar
  124. 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
  125. Marini, A., Suma, V., Baccichetti, C., and Lenzini, E.: A case of septic miscarriage, a probable complication of chorion villus sampling. Prenat. Diagn. 8: 399–400, 1988.PubMedCrossRefGoogle Scholar
  126. 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. Congen. Anom. (Japan) 17: 507–512, 1977.Google Scholar
  127. Mcadden, D.E., Pantzer, J.T., and Langlois, S.: Parental origin of triploidy: digyny, not diandry [abstract 28]. Mod. Pathol. 7: 5P, 1994.Google Scholar
  128. Mcntyre, 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.CrossRefGoogle Scholar
  129. Mcean, J.M.: Early embryo loss. Lancet 1:1033–1034, 1987. Melius, F.A., Julian, T.M., and Nagel, T.C.: Prolonged retention of intrauterine bones. Obstet. Gynecol. 78: 919–921, 1991.Google Scholar
  130. 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
  131. 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
  132. 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
  133. Mills, J.L., Simpson, J.L., Driscoll, S.G., Jovanovic-Peterson, L., van Allen, M., Aarons, J.H., Metzger, B., Bieber, F.R., 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
  134. 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
  135. Monrozies, M.: La gravité actuelle de l’avortement provoqué. Gynecol. Obstet. (Paris) 70: 79–94, 1971.Google Scholar
  136. Moore, K.L.: The Developing Human: Clinically Oriented Embryology. 3rd Ed. Saunders, Philadelphia, 1982.Google Scholar
  137. 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
  138. 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
  139. Mueller-Eckhardt, G., Heine, O., and Polten, B.: IVIG to prevent recurrent spontaneous abortion. Lancet 337: 424–425, 1991.PubMedCrossRefGoogle Scholar
  140. 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
  141. 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
  142. 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
  143. 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
  144. 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
  145. Olding, L., Benirschke, K., and Oldstone, M.B.A.: Inhibition of mitosis of lymphocytes from human adults by lymphocytes from newborns. Clin. Immun. Immunopathol. 3: 79–89, 1974.CrossRefGoogle Scholar
  146. Ornoy, A., Kohn, G., Zur, Z.B., Weinstein, D., and Cohen, M.M.: Triploidy in human abortions. Teratology 18: 315–320, 1978.PubMedCrossRefGoogle Scholar
  147. 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
  148. Palomaki, J.F., and Little, A.B.: Surgical management of abortion. N. Engl. J. Med. 287: 752–754, 1972.PubMedCrossRefGoogle Scholar
  149. Parazzini, F., Acacia, B., Faden, D., Lovotti, M., Marelli, G., and Cortelazzo, S.: Antiphospholipid antibodies and recurrent abortion. Obstet. Gynecol. 77: 854–858, 1991.PubMedGoogle Scholar
  150. Philippe, E.: Pathologie Foeto-Placentaire. Masson, Paris, 1986.Google Scholar
  151. Philippe, E., and Boué, E.: Le placenta des aberrations chromosomiques létales. Ann. Anat. Pathol. (Paris) 14: 249–266, 1969.Google Scholar
  152. 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
  153. Portnoi, M.-F., 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
  154. 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
  155. Pridjian, G., and Moawad, A.H.: Missed abortion: still appropriate terminology ? Am. J. Obstet. Gynecol. 161: 261–262, 1989.PubMedGoogle Scholar
  156. 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
  157. Qureshi, F., 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
  158. Rehder, H., and Gropp, A.: Triploidie als Ursache fötoplacentarer Fehlbildung bei Abortus. Verh. Dtsch. Ges. Pathol. 55: 525–529, 1971.PubMedGoogle Scholar
  159. Rehder, H., Coerdt, W., Eggers, R., Klink, F., 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
  160. Rhoads, G.G., Jackson, L.G., Schlesselman, 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, P.H., 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.PubMedCrossRefGoogle Scholar
  161. 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
  162. 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
  163. 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
  164. Sadovsky, A., and Laufer, A.: Placental changes in early spontaneous abortion. Obstet. Gynecol. 17: 678–683, 1961.PubMedGoogle Scholar
  165. 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
  166. 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
  167. Sailer, 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.Google Scholar
  168. Sasaki, M., Makino, S., Muramoto, J.-I., Ikeuchi, T., and Shimba, H.: A chromosome survey of induced abortuses in a Japanese population. Chromosoma 20: 267–283, 1967.PubMedCrossRefGoogle Scholar
  169. 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
  170. Schulman, H., Kaiser, I.H., and Randolph, G.: Outpatient saline abortion. Obstet. Gynecol. 37: 521–526, 1971.PubMedGoogle Scholar
  171. Schulze, B., Schlesinger, C., and Miller, K.: Chromosomal mosaicism confined to chorionic tissue. Prenat. Diagn. 7: 451–453, 1987.PubMedCrossRefGoogle Scholar
  172. 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
  173. Scott, R.: Limb abnormalities after chorionic villus sampling. Lancet 337: 1038–1039, 1991.PubMedCrossRefGoogle Scholar
  174. Segal, S., Ornoy, A., Bercovici, B., Antebi, S.O., and Polishuk, W.Z.: Placental pathology in midtrimester pregnancies interrupted by intra-amniotic injection of hyper-tonic urea. Br. J. Obstet. Gynaecol. 83: 156–159, 1976.PubMedCrossRefGoogle Scholar
  175. 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
  176. 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
  177. Shepard, T.H., Fantel, A.G., and Fitzsimmons, J.: Congenital defect rates among spontaneous abortuses: twenty years of monitoring. Teratology 39: 325–331, 1989a.PubMedCrossRefGoogle Scholar
  178. 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
  179. 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
  180. 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
  181. Shettles, L.: The great preponderance of human males conceived. Am. J. Obstet. Gynecol. 89: 130–133, 1964.PubMedGoogle Scholar
  182. 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
  183. 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
  184. Singh, R.P., and Carr, D.H.: Anatomic findings in human abortions of known chromosomal constitution. Obstet. Gynecol. 29: 806–818, 1967.PubMedGoogle Scholar
  185. Singh, R.P., and Carr, D.H.: Congenital anomalies in embryos with normal chromosomes. Biol. Neonat. 13: 121–128, 1968.PubMedCrossRefGoogle Scholar
  186. Smith, A., and Gaha, T.J.: Data on families of chromosome translocation carriers ascertained because of habitual abortion. Austr. N.Z. J. Obstet. Gynaecol. 30: 57–62, 1990.CrossRefGoogle Scholar
  187. 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
  188. Stein, Z.A.: A woman’s age: childbearing and child rearing. Am. J. Epidemiol. 121: 327–342, 1985.PubMedGoogle Scholar
  189. 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
  190. 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
  191. 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
  192. 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. Prenat. Diagn. 9: 673–676, 1989.PubMedCrossRefGoogle Scholar
  193. Stirrat, G.M.: Recurrent miscarriage. I. Definition and epidemiology. Lancet 336: 673–675, 1990PubMedCrossRefGoogle Scholar
  194. Stirrat, G.M.: Recurrent miscarriage. II. Clinical associations, causes, and management. Lancet 336: 728–733, 1990b.PubMedCrossRefGoogle Scholar
  195. 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
  196. 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
  197. 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
  198. 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
  199. 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 in villi (direct and culture) with normal (46,XX) amniotic fluid and neonatal blood. Prenat. Diagn. 9: 467–472, 1989.PubMedCrossRefGoogle Scholar
  200. 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
  201. Verjaal, M., Leschot, N.J., Wolf, H., and Treffers, P.E.: Karyotypic differences between cells from placenta and other fetal tissues. Prenat. Diagn. 7: 343–348, 1987.PubMedCrossRefGoogle Scholar
  202. Vernof, K.K., Ney, J.A., and Dewald, G.W.: Pure placental trisomy 16 associated with a 46,XY infant and severe pre-eclampsia: a case report [abstract]. Am. J. Obstet. Gynecol. 166: 434, 1992.Google Scholar
  203. 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
  204. Vogel, M.: Placentabefunde beim Abort: ein Beitrag zur Patho-Morphologie placentarer Entwicklungsstörungen. Virchows Arch. [A] 346: 212–223, 1969.CrossRefGoogle Scholar
  205. Vogel, M.: Atlas der Morphologischen Plazentadiagnostik. Springer-Verlag, Berlin, 1992.CrossRefGoogle Scholar
  206. Wade, R.V., and Young, S.R.: Analysis of fetal loss after transcervical chorionic villus sampling: a review of 719 patients. Am. J. Obstet. Gynecol. 161: 513–519, 1989.PubMedGoogle Scholar
  207. Wall, R.L., and Hertig, A.T.: Habitual abortion. Am. J. Obstet. Gynecol. 56: 1127–1133, 1948.PubMedGoogle Scholar
  208. 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
  209. 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
  210. 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
  211. Williams, J., Wang, B.T., Rubin, C.H., and Aiken-Hunting, D.: Chorionic villus sampling: experience with 3016 cases performed by a single operator. Obstet. Gynecol. 80: 1023–1029, 1992.PubMedGoogle Scholar
  212. Yamamoto, M., and Watanabe, G.: Epidemiology of gross chromosomal anomalies at early embryonic stage of pregnancy. Contrib. Epidemiol. Biostatist. 1: 101–106, 1979.Google Scholar
  213. Zerres, K., Niesen, M., Schwanitz, G., and Hansmann, M.: Trisomie 22—Pränatale Befunde unterschiedlicher Entwicklungsstadien. Geburtshilfe Frauenheilkd. 48: 720–723, 1988.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1995

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

Personalised recommendations