Spontaneous Abortion and the Pathology of Early Pregnancy

  • T. Yee Khong

The medical profession classifi es abortion as induced or spontaneous. The lay public, however, tends to equate the term abortion with one that is induced, whether therapeutically, self, or criminal, and to associate the term miscarriage with spontaneous abortion (Beard et al. 1985).

Spontaneous abortion is usually defi ned as the involuntary loss of a conceptus before the fetus has attained viability (World Health Organization 1970). Although this appears to be a simple defi nition, there are numerous diffi culties with it. First, the gestational age at which the fetus attains viability is subject to much debate, especially with the advent of improved medical care of infants who are born prematurely or are of very low birth weight. Second, the legal criteria on viability of the fetus varies among jurisdictions, and definitions of spontaneous abortion have been given as a pregnancy loss at gestational ages varying up to between 20 and 28 weeks (World Health Organization 1970). These differences make it diffi cult to compare data, and a new defi nition—“complete loss of conceptuses weighing less than 500g or, when birth weight is unavailable, the corresponding gestation age (22 weeks) or body-length (25 cm crown–heel), irrespective of whether or not there is any sign of life”—is recommended (World Health Organization 1975).


Celiac Disease Obstet Gynecol Ectopic Pregnancy Spontaneous Abortion Hydatidiform Mole 
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. Althuisius SM, Dekker GA (2005) A five century evolution of cervical incompetence as a clinical entity. Curr Pharm Des 11:687–697.PubMedCrossRefGoogle Scholar
  2. Andersen AMN, Hansen KD, Andersen PK, Davey Smith G (2004) Advanced paternal age and risk of fetal death: a cohort study. Am J Epidemiol 160:1214–1222.PubMedCrossRefGoogle Scholar
  3. Andersen AM, Vastrup P, Wohlfahrt J, Andersen PK, Olsen J, Melbye M (2002) Fever in pregnancy and risk of fetal death: a cohort study. Lancet 360:1552–1556.PubMedCrossRefGoogle Scholar
  4. Ankum WM, Mol BW, Van der Veen F, Bossuyt PM (1996) Risk factors for ectopic pregnancy: a meta-analysis. Fertil Steril 65:1093–1099.PubMedGoogle Scholar
  5. Barak S, Oettinger M, Perri A, Cohen HI, Barenboym R, Ophir E (2005) Frozen section examination of endo-metrial curettings in the diagnosis of ectopic pregnancy. Acta Obstet Gynecol Scand 84:43–47.PubMedCrossRefGoogle Scholar
  6. Beard RW, Mowbray JF, Pinker GD (1985) Miscarriage or abortion. Lancet 2:1122–1123.PubMedCrossRefGoogle Scholar
  7. Berkowitz RS, Bernstein MR, Harlow BL, et al. (1995) Case-control study of risk factors for partial molar pregnancy. Am J Obstet Gynecol 173:788–794.PubMedCrossRefGoogle Scholar
  8. Bloch SK (1976) Occult pregnancy. A pilot study. Obstet Gynecol 48:365–368.PubMedGoogle Scholar
  9. Bouyer J, Coste J, Shojaei T, et al. (2003) Risk factors for ectopic pregnancy: a comprehensive analysis based on a large case-control, population-based study in France. Am J Epidemiol 157:185– 194.PubMedCrossRefGoogle Scholar
  10. Brinton LA, Wu BZ, Wang W, et al. (1989) Gestational trophoblastic disease: a case-control study from the People's Republic of China. Am J Obstet Gynecol 161:121–127.PubMedGoogle Scholar
  11. Bristow RE, Shumway JB, Khouzami AN, Witter FR (1996) Complete hydatidiform mole and surviving coexistent twin. Obstet Gynecol Surv 51:705–709.PubMedCrossRefGoogle Scholar
  12. Canobbio MM, Mair DD, van der Velde M, Koos BJ (1996) Pregnancy outcomes after the Fontan repair. J Am Coll Cardiol 28:763–767.PubMedCrossRefGoogle Scholar
  13. Castrillon DH, Sun D, Weremowicz S, Fisher RA, Crum CP, Genest DR (2001) Discrimination of complete hydatidiform mole from its mimics by immunohis-tochemistry of the paternally imprinted gene product p57KIP2. Am J Surg Pathol 25:1225–1230.PubMedCrossRefGoogle Scholar
  14. Chaouat G, Ledee-bataill N, Dubanchet S (2004a) Is there a place for immunomodulation in assisted reproduction techniques? J Reprod Immunol 62:29–39.CrossRefGoogle Scholar
  15. Chaouat G, Ledee-Bataille N, Dubanchet S, Zourbas S, Sandra O, Martal J (2004b) Reproductive immunology 2003: reassessing the Th1/Th2 paradigm? Immunol Lett 92:207–214.CrossRefGoogle Scholar
  16. Cheah PL, Looi LM, Sivanesaratnam V (1993) Hydatidi-form molar pregnancy in Malaysian women: a histo-pathological study from the University Hospital, Kuala Lumpur. Malays J Pathol 15:59–63.PubMedGoogle Scholar
  17. Cheung ANY, Ngan HYS, Collins RJ, Wong YL (1994) Assessment of cell proliferation in hydatidiform mole using monoclonal antibody MIB1 to Ki-67 antigen. J Clin Pathol 47:601–604.PubMedCrossRefGoogle Scholar
  18. Clowse ME, Magder LS, Witter F, Petri M (2005) The impact of increased lupus activity on obstetric outcomes. Arthritis Rheum 52:514–521.PubMedCrossRefGoogle Scholar
  19. Correa A, Gray RH, Cohen R, et al. (1996) Ethylene glycol ethers and risks of spontaneous abortion and subfertility. Am J Epidemiol 143:707–717.PubMedGoogle Scholar
  20. Coulam CB, Stern JJ (1994) Endocrine factors associated with recurrent spontaneous abortion. Clin Obstet Gynecol 37:730–744.PubMedCrossRefGoogle Scholar
  21. Dawood MY (1994) Corpus luteal insufficiency. Curr Opin Obstet Gynecol 6:121–127.PubMedGoogle Scholar
  22. de la Rochebrochard E, Thonneau P (2002) Paternal age and maternal age are risk factors for miscarriage; results of a multicentre European study. Hum Reprod 17:1649–1656.PubMedCrossRefGoogle Scholar
  23. dos Santos Silva I, Higgins C, et al. (2005) Birthweight and other pregnancy outcomes in a cohort of women with pre-gestational insulin-treated diabetes melli-tus, Scotland, 1979–95. Diabet Med 22:440–447.PubMedCrossRefGoogle Scholar
  24. Dosiou C, Giudice LC (2005) Natural killer cells in pregnancy and recurrent pregnancy loss: endocrine and immunologic perspectives. Endocr Rev 26:44–62.PubMedCrossRefGoogle Scholar
  25. Edwards JH, Yuncken C, Rushton DI, Richards S, Mittwoch U (1967) Three cases of triploidy in man. Cytogenetics 6:81–104.PubMedCrossRefGoogle Scholar
  26. Ellish NJ, Saboda K, O'Connor J, Nasca PC, Stanek EJ, Boyle C (1996) A prospective study of early pregnancy loss. Hum Reprod 11:406–412.PubMedGoogle Scholar
  27. Erel CT, Kaleli S, Oral E, et al. (1996) DNA ploidy of ectopic pregnancy and first trimester spontaneous abortion investigated by flow cytometry. Acta Obstet Gynecol Scand 75:881–885.PubMedCrossRefGoogle Scholar
  28. Farrow A, Farrow SC, Little R, Golding J (1996) The repeatability of self-reported exposure after miscarriage. ALSPAC Study Team. Avon Longitudinal Study of Pregnancy and Childhood. Int J Epidemiol 25:797–806.PubMedCrossRefGoogle Scholar
  29. Fox H (1993) Histological classification of tissue from spontaneous abortions: a valueless exercise? Histo-pathology 22:599–600.Google Scholar
  30. Fox H (1995) Ectopic pregnancy. In: Fox H, ed. Haines and Taylor Obstetrical and Gynaecological Pathology. Churchill Livingstone, London, pp. 1113–1136.Google Scholar
  31. Fritz B, Aslan M, Kalscheuer V, Ramsing M, Saar K, Fuchs B, Rehder H (2001) Low incidence of UPD in spontaneous abortions beyond the 5th gestational week. Eur J Hum Genet 9:910–916.PubMedCrossRefGoogle Scholar
  32. Gaudoin MR, Coulter KL, Robins AM, Verghese A, Hanretty KP (1996) Is the incidence of ovarian ectopic pregnancy increasing? Eur J Obstet Gynecol Reprod Biol 70:141–143.PubMedCrossRefGoogle Scholar
  33. Genest DR, Laborde O, Berkowitz RS, Goldstein DP, Bernstein MR, Lage J (1991) A clinicopathologic study of 153 cases of complete hydatidiform mole (1980–1990): histologic grade lacks prognostic sig-nificance. Obstet Gynecol 78:402–409.PubMedGoogle Scholar
  34. Genest DR, Roberts D, Boyd T, Bieber FR (1995) Feto-placental histology as a predictor of karyotype: a controlled study of spontaneous first trimester abortions. Hum Pathol 26:201–209.PubMedCrossRefGoogle Scholar
  35. Goldzieher JW, Benigno BB (1958) The treatment of threatened and recurrent abortion; a critical review. Am J Obstet Gynecol 75:1202–1214.PubMedGoogle Scholar
  36. Greco L, Veneziano A, Di Donato L, et al. (2004) Undi-agnosed coeliac disease does not appear to be associated with unfavourable outcome of pregnancy. Gut 53:149–151.PubMedCrossRefGoogle Scholar
  37. Green DM, Whitton JA, Stovall M, et al. (2002) Pregnancy outcome of female survivors of childhood cancer: a report from the Childhood Cancer Survivor Study. Am J Obstet Gynecol 187:1070– 1080.PubMedCrossRefGoogle Scholar
  38. Green DM, Whitton JA, Stovall M, et al. (2003) Pregnancy outcome of partners of male survivors of childhood cancer: a report from the Childhood Cancer Survivor Study. J Clin Oncol 21:716–721.PubMedCrossRefGoogle Scholar
  39. Harris JWS, Ramsey EM (1966) The morphology of human uteroplacental vasculature. Contrib Embryol 38:43–58.Google Scholar
  40. Hassold TJ, Chen N, Funkhouser J, et al. (1980) A cyto-genetic study of 1000 spontaneous abortions. Ann Hum Genet 44:151–178.PubMedCrossRefGoogle Scholar
  41. Hay PE (2004) Bacterial vaginosis and miscarriage. Curr Opin Infect Dis 17:41–44.PubMedCrossRefGoogle Scholar
  42. Hempstock J, Jauniaux E, Greenwold N, Burton GJ (2003) The contribution of placental oxidative stress to early pregnancy failure. Hum Pathol 34:1265– 1275.PubMedCrossRefGoogle Scholar
  43. Henriksen TB, Hjollund NH, Jensen TK, et al. (2004) Alcohol consumption at the time of conception and spontaneous abortion. Am J Epidemiol 160:661–667.PubMedCrossRefGoogle Scholar
  44. Hertig AT, Sheldon WH (1947) Hydatidiform mole: a pathologicoclinical correlation of 200 cases. Am J Obstet Gynecol 53:1–36.PubMedGoogle Scholar
  45. Hill JA, Melling GC, Johnson PM (1995) Immunohisto-chemical studies of human uteroplacental tissues from first-trimester spontaneous abortion. Am J Obstet Gynecol 173:90–96.PubMedCrossRefGoogle Scholar
  46. Hogge WA, Byrnes AL, Lanasa MC, Surti U (2003) The clinical use of karyotyping spontaneous abortions. Am J Obstet Gynecol 189:397–400; discussion 400–402.PubMedCrossRefGoogle Scholar
  47. Holley JL, Bernardini J, Quadri KH, Greenberg A, Laifer SA (1996) Pregnancy outcomes in a prospective matched control study of pregnancy and renal disease. Clin Nephrol 45:77–82.PubMedGoogle Scholar
  48. Houwert-de Jong MH, Bruinse HW, et al. (1990) Early recurrent miscarriage: histology of conception products. Br J Obstet Gynaecol 97:533–535.PubMedGoogle Scholar
  49. Hughes EG, Brennan BG (1996) Does cigarette smoking impair natural or assisted fecundity? Fertil Steril 66:679–689.PubMedGoogle Scholar
  50. Hustin J, Jauniaux E, Schaaps JP (1990) Histological study of the materno-embryonic interface in spontaneous abortion. Placenta 11:477–486.PubMedCrossRefGoogle Scholar
  51. Jacques SM, Qureshi F, Doss BJ, Munkarah A (1998) Intraplacental choriocarcinoma associated with viable pregnancy: pathologic features and implications for the mother and infant. Pediatr Dev Pathol 1:380–387.PubMedCrossRefGoogle Scholar
  52. Jauniaux E, Zaidi J, Jurkovic D, Campbell S, Hustin J (1994) Comparison of colour Doppler features and pathological findings in complicated early pregnancy. Hum Reprod 9:2432–2437.PubMedGoogle Scholar
  53. Johnson A, Wapner RJ, Davis GH, Jackson LG (1990) Mosaicism in chorionic villus sampling: an association with poor perinatal outcome. Obstet Gynecol 75:573–577.PubMedGoogle Scholar
  54. Kalousek DK (1994) Current topic: confined placental mosaicism and intrauterine fetal development. Placenta 15:219–230.PubMedCrossRefGoogle Scholar
  55. Kalousek DK, Barrett IJ, McGillivray BC (1989) Placen-tal mosaicism and intrauterine survival of trisomies 13 and 18. Am J Hum Genet 44:338–343.PubMedGoogle Scholar
  56. Kalousek DK, Fitch N, Paradice BA (1990) Pathology of the Human Embryo and Previable Fetus. Springer-Verlag, New York.Google Scholar
  57. Karikoski R, Aine R, Heinonen PK (1993) Abnormal embryogenesis in the etiology of ectopic pregnancy. Gynecol Obstet Invest 36:158–162.PubMedCrossRefGoogle Scholar
  58. Keep D, Zaragoza MV, Hassold T, Redline RW (1996) Very early complete hydatidiform mole. Hum Pathol 27:708–713.PubMedCrossRefGoogle Scholar
  59. Kendrick JS, Tierney EF, Lawson HW, Strauss LT, Klein L, Atrash HK (1996) Previous cesarean delivery and the risk of ectopic pregnancy. Obstet Gynecol 87:297–301.PubMedCrossRefGoogle Scholar
  60. Khong TY, Ismail SM (2005) Handbook of Endometrial Pathology. Taylor and Francis, New York.Google Scholar
  61. Khong TY, Liddell HS, Robertson WB (1987) Defective haemochorial placentation as a cause of miscarriage: a preliminary study. Br J Obstet Gynaecol 94:649– 655.PubMedGoogle Scholar
  62. Klatt EC (1995) Pathologic examination of fetal specimens from dilation and evacuation procedures. Am J Clin Pathol 103:415–418.PubMedGoogle Scholar
  63. Kline J, Levin B, Kinney A, Stein Z, Susser M, Warbur-ton D (1995) Cigarette smoking and spontaneous abortion of known karyotype. Precise data but uncertain inferences. Am J Epidemiol 141:417–427.Google Scholar
  64. Kondo Y, Tsukishiro S, Tanemura M, Sugiura-Ogasawara M, Suzumori K, Sonta S (2004) Maternal uniparental disomy of chromosome 16 in a case of spontaneous abortion. J Hum Genet 49:177–181.PubMedCrossRefGoogle Scholar
  65. Kujovich JL (2004) Thrombophilia and pregnancy complications. Am J Obstet Gynecol 191:412–424.PubMedCrossRefGoogle Scholar
  66. Lage JM, Bagg A (1996) Hydatidiform moles: DNA flow cytometry, image analysis and selected topics in molecular biology. Histopathology 28:379–382.PubMedCrossRefGoogle Scholar
  67. Lage JM, Mark SD, Roberts DJ, Goldstein DP, Bernstein MR, Berkowitz RS (1992) A flow cytometric study of 137 fresh hydropic placentas: correlation between types of hydatidiform moles and nuclear DNA ploidy. Obstet Gynecol 79:403–410.PubMedCrossRefGoogle Scholar
  68. Lan J, van den Brule AJ, Hemrika DJ, et al. (1995) Chlamydia trachomatis and ectopic pregnancy: retrospective analysis of salpingectomy specimens, endometrial biopsies, and cervical smears. J Clin Pathol 48:815–819.PubMedCrossRefGoogle Scholar
  69. Lauritsen JG (1976) Aetiology of spontaneous abortion. A cytogenetic and epidemiological study of 288 abortuses and their parents. Acta Obstet Gynecol Scand Suppl 52:1–29.Google Scholar
  70. Lazda EJ, Sams VR (1995) The effects of gemeprost on the second trimester fetus. Br J Obstet Gynaecol 102:731–734.PubMedGoogle Scholar
  71. Lehner R, Kucera E, Jirecek S, Egarter C, Husslein P (2000) Ectopic pregnancy. Arch Gynecol Obstet 263:87–92.PubMedCrossRefGoogle Scholar
  72. Logman JF, de Vries LE, Hemels ME, Khattak S, Einar-son TR (2005) Paternal organic solvent exposure and adverse pregnancy outcomes: a meta-analysis. Am J Ind Med 47:37–44.PubMedCrossRefGoogle Scholar
  73. Marcovici I, Rosenzweig BA, Brill AI, Khan M, Scom-megna A (1994) Cervical pregnancy: case reports and a current literature review. Obstet Gynecol Surv 49:49–55.PubMedCrossRefGoogle Scholar
  74. Martinelli P, Troncone R, Paparo F, et al. (2000) Coeliac disease and unfavourable outcome of pregnancy. Gut 46:332–335.PubMedCrossRefGoogle Scholar
  75. Matsui H, Iitsuka Y, Yamazawa K, Tanaka N, Seki K, Sekiya S (2003) Changes in the incidence of molar pregnancies. A population-based study in Chiba Prefecture and Japan between 1974 and 2000. Hum Reprod 18:172–175.PubMedCrossRefGoogle Scholar
  76. McElhatton PR, Garbis HM, Elefant E, et al. (1996) The outcome of pregnancy in 689 women exposed to therapeutic doses of antidepressants. A collaborative study of the European Network of Teratology Information Services (ENTIS). Reprod Toxicol 10:285– 294.PubMedGoogle Scholar
  77. Meroni PL, di Simone N, Testoni C, D'Asta M, Acaia B, Caruso A (2004) Antiphospholipid antibodies as cause of pregnancy loss. Lupus 13:649–652.PubMedCrossRefGoogle Scholar
  78. Minguillon C, Eiben B, Bahr-Porsch S, Vogel M, Hans-mann I (1989) The predictive value of chorionic villus histology for identifying chromosomally normal and abnormal spontaneous abortions. Hum Genet 82:373–376.PubMedCrossRefGoogle Scholar
  79. Moffett A, Regan L, Braude P (2004) Natural killer cells, miscarriage, and infertility. Br Med J 329:1283– 1285.CrossRefGoogle Scholar
  80. Mol BW, Ankum WM, Bossuyt PM, Van der Veen F (1995) Contraception and the risk of ectopic pregnancy: a meta-analysis. Contraception 52:337– 341.PubMedCrossRefGoogle Scholar
  81. Montes M, Roberts D, Berkowitz RS, Genest DR (1996) Prevalence and significance of implantation site tro-phoblastic atypia in hydatidiform moles and spontaneous abortions. Am J Clin Pathol 105:411–416.PubMedGoogle Scholar
  82. Napolitano PG, Vu K, Rosa C (1996) Pregnancy after failed tubal sterilization. J Reprod Med 41:609–613.PubMedGoogle Scholar
  83. Nayar R, Lage JM (1996) Placental changes in a first trimester missed abortion in maternal systemic lupus erythematosus with antiphospholipid syndrome; a case report and review of the literature. Hum Pathol 27:201–206.PubMedCrossRefGoogle Scholar
  84. Nielsen GL, Skriver MV, Pedersen L, Sorensen HT (2004) Danish group reanalyses miscarriage in NSAID users. Br Med J 328:109.CrossRefGoogle Scholar
  85. Oksenberg JR, Persitz E, Amar A, et al. (1983) Mixed lymphocyte reactivity nonresponsiveness in couples with multiple spontaneous abortions. Fertil Steril 39:525–529.PubMedGoogle Scholar
  86. Paradinas FJ, Browne P, Fisher RA, Foskett M, Bagshawe KD, Newlands E (1996) A clinical, histopathological and flow cytometric study of 149 complete moles, 146 partial moles and 107 non-molar hydropic abortions. Histopathology 28:101– 110.PubMedCrossRefGoogle Scholar
  87. Paradinas FJ, Fisher RA, Browne P, Newlands ES (1997) Diploid hydatidiform moles with fetal red blood cells in molar villi. 1. Pathology, incidence, and prognosis. J Pathol 181:183–188.PubMedCrossRefGoogle Scholar
  88. Peterson HB, Xia Z, Hughes JM, Wilcox LS, Tylor LR, Trussell J (1997) The risk of ectopic pregnancy after tubal sterilization. U.S. Collaborative Review of Sterilization Working Group. N Engl J Med 336:762–767.PubMedCrossRefGoogle Scholar
  89. Phillips-Howard PA, Wood D (1996) The safety of anti-malarial drugs in pregnancy. Drug Saf 14:131–145.PubMedCrossRefGoogle Scholar
  90. Picton SV, Bose-Haider B, Lendon M, Hancock BW, Campbell RH (1995) Simultaneous choriocarcinoma in mother and newborn infant. Med Pediatr Oncol 25:475–478.PubMedCrossRefGoogle Scholar
  91. Prigoshin N, Tambutti M, Larriba J, Gogorza S, Testa R (2004) Cytokine gene polymorphisms in recurrent pregnancy loss of unknown cause. Am J Reprod Immunol 52:36–41.PubMedCrossRefGoogle Scholar
  92. Prummel MF, Wiersinga WM (2004) Thyroid autoim-munity and miscarriage. Eur J Endocrinol 150:751– 755.PubMedCrossRefGoogle Scholar
  93. Qasim SM, Bohrer MK, Kemmann E (1996) Recurrent cervical pregnancy after assisted reproduction by intrafallopian transfer. Obstet Gynecol 87:831–832.PubMedGoogle Scholar
  94. Rabbani I, Polson DW (2005) Heterotopic pregnancy is not rare. A case report and literature review. J Obstet Gynaecol 25:204–205.Google Scholar
  95. Ramirez NC, Lawrence WD, Ginsburg KA (1996) Ectopic pregnancy. A recent five-year study and review of the last 50 years' literature. J Reprod Med 41:733–740.Google Scholar
  96. Raziel A, Mordechai E, Schachter M, Friedler S, Pansky M, Ron-El R (2004) A comparison of the incidence, presentation, and management of ovarian pregnancies between two periods of time. J Am Assoc Gynecol Laparosc 11:191–194.PubMedCrossRefGoogle Scholar
  97. Redline RW, Zaragoza M, Hassold T (1996) Prevalence of developmental and inflammatory lesions in non-molar first-trimester spontaneous abortions. Hum Pathol 30:93–100.CrossRefGoogle Scholar
  98. Rehder H, Coerdt W, Eggers R, Klink F, Schwinger E (1989) Is there a correlation between morphological and cytogenetic findings in placental tissue from early missed abortions? Hum Genet 82:377–385.PubMedCrossRefGoogle Scholar
  99. Romaguera RL, Rodriguez MM, Bruce JH, et al. (2004) Molar gestations and hydropic abortions differentiated by p57 immunostaining. Fetal Pediatr Pathol 23:181–190.PubMedCrossRefGoogle Scholar
  100. Rowland AS, Baird DD, Shore DL, Darden B, Wilcox AJ (1996) Ethylene oxide exposure may increase the risk of spontaneous abortion, preterm birth, and post-term birth. Epidemiology 7:363–368.PubMedCrossRefGoogle Scholar
  101. Rushton DI (1978) Simplified classification of spontaneous abortions. J Med Genet 15:1–9.PubMedCrossRefGoogle Scholar
  102. Rushton DI (1984) The classification and mechanisms of spontaneous abortion. Perspect Pediatr Pathol 8:269–287.PubMedGoogle Scholar
  103. Salafia C, Maier D, Vogel C, Pezzullo J, Burns J, Silber-man L (1993) Placental and decidual histology in spontaneous abortion: detailed description and correlations with chromosome number. Obstet Gynecol 82:295–303.PubMedGoogle Scholar
  104. Salim R, Regan L, Woelfer B, Backos M, Jurkovic D (2003) A comparative study of the morphology of congenital uterine anomalies in women with and without a history of recurrent first trimester miscarriage. Hum Reprod 18:162–166.PubMedCrossRefGoogle Scholar
  105. Sanders JE, Hawley J, Levy W, et al. (1996) Pregnancies following high-dose cyclophosphamide with or without high-dose busulfan or total-body irradiation and bone marrow transplantation. Blood 87:3045– 3052.PubMedGoogle Scholar
  106. Schaefer C, Amoura-Elefant E, Vial T, et al. (1996) Pregnancy outcome after prenatal quinolone exposure. Evaluation of a case registry of the European Network of Teratology Information Services (ENTIS). Eur J Obstet Gynecol Reprod Biol 69:83–89.PubMedCrossRefGoogle Scholar
  107. Signorello LB, McLaughlin JK (2004) Maternal caffeine consumption and spontaneous abortion: a review of the epidemiologic evidence. Epidemiology 15:229– 239.PubMedCrossRefGoogle Scholar
  108. Simpson JL, Elias S, Martin AO (1981) Parental chromosomal rearrangements associated with repetitive spontaneous abortions. Fertil Steril 36:584– 590.PubMedGoogle Scholar
  109. Simpson JL, Gray RH, Queenan JT, et al. (1996) Further evidence that infection is an infrequent cause of first trimester spontaneous abortion. Hum Reprod 11:2058–2060.PubMedGoogle Scholar
  110. Skjeldestad FE, Atrash HK (1997) Evaluation of induced abortion as a risk factor for ectopic pregnancy. A case-control study. Acta Obstet Gynecol Scand 76:151–158.PubMedCrossRefGoogle Scholar
  111. Skjeldestad FE, Kendrick JS, Atrash HK, Daltveit AK (1997) Increasing incidence of ectopic pregnancy in one Norwegian county—a population based study, 1970–1993. Acta Obstet Gynecol Scand 76:159–165.PubMedCrossRefGoogle Scholar
  112. Smith NM (2000) Broadsheet number 56: Mechanisms of fetal loss. Pathology 32:107–115.PubMedCrossRefGoogle Scholar
  113. Soto-Wright V, Bernstein M, Goldstein DP, Berkowitz RS (1995) The changing clinical presentation of complete molar pregnancy. Obstet Gynecol 86:775–779.PubMedCrossRefGoogle Scholar
  114. Spandorfer SD, Menzin AW, Barnhart KT, LiVolsi VA, Pfeifer SM (1996) Efficacy of frozen-section evaluation of uterine curettings in the diagnosis of ectopic pregnancy. Am J Obstet Gynecol 175:603–605.PubMedCrossRefGoogle Scholar
  115. Stern JJ, Dorfmann AD, Gutierrez-Najar AJ, Cerrillo M, Coulam CB (1996) Frequency of abnormal karyo-types among abortuses from women with and without a history of recurrent spontaneous abortion. Fertil Steril 65:250–253.PubMedGoogle Scholar
  116. Summers PR (1994) Microbiology relevant to recurrent miscarriage. Clin Obstet Gynecol 37:722–729.PubMedCrossRefGoogle Scholar
  117. Szulman AE, Surti U (1978) The syndromes of hydatidi-form mole. II. Morphologic evolution of the complete and partial mole. Am J Obstet Gynecol 132:20–27.PubMedGoogle Scholar
  118. Taskinen H, Kyyronen P, Hemminki K, Hoikkala M, Lajunen K, Lindbohm ML (1994) Laboratory work and pregnancy outcome. J Occup Med 36:311–319.PubMedCrossRefGoogle Scholar
  119. Tata LJ, Card TR, Logan RF, Hubbard RB, Smith CJ, West J (2005) Fertility and pregnancy-related events in women with celiac disease: a population-based cohort study. Gastroenterology 128:849–855.PubMedCrossRefGoogle Scholar
  120. Thaker HM, Berlin A, Tycko B, et al. (2004) Immuno-histochemistry for the imprinted gene product IPL/ PHLDA2 for facilitating the differential diagnosis of complete hydatidiform mole. J Reprod Med 49:630– 636.PubMedGoogle Scholar
  121. Toikkanen S, Joensuu H, Erkkola R (1993) DNA aneu-ploidy in ectopic pregnancy and spontaneous abortions. Eur J Obstet Gynecol Reprod Biol 51:9–13.PubMedCrossRefGoogle Scholar
  122. Valentin L, Sladkevicius P, Laurini R, Soderberg H, Marsal K (1996) Uteroplacental and luteal circulation in normal first-trimester pregnancies: Doppler ultra-sonographic and morphologic study. Am J Obstet Gynecol 174:768–775.PubMedCrossRefGoogle Scholar
  123. Van Horn JT, Craven C, Ward K, Branch DW, Silver RM (2004) Histologic features of placentas and abortion specimens from women with antiphospholipid and antiphospholipid-like syndromes. Placenta 25:642– 648.PubMedCrossRefGoogle Scholar
  124. van Lijnschoten G, Arends JW, De La Fuente AA, Schouten HJ, Geraedts JP (1993) Intra- and inter-observer variation in the interpretation of histologi-cal features suggesting chromosomal abnormality in early abortion specimens. Histopathology 22:25–29.PubMedCrossRefGoogle Scholar
  125. Varras M, Akrivis C, Hadjopoulos G, Antoniou N (2003) Heterotopic pregnancy in a natural conception cycle presenting with tubal rupture: a case report and review of the literature. Eur J Obstet Gynecol Reprod Biol 106:79–82.PubMedCrossRefGoogle Scholar
  126. Venners SA, Wang X, Chen C, et al. (2004) Paternal smoking and pregnancy loss: a prospective study using a biomarker of pregnancy. Am J Epidemiol 159:993–1001.PubMedCrossRefGoogle Scholar
  127. Vorsanova SG, Kolotii AD, Iourov IY, et al. (2005) Evidence for high frequency of chromosomal mosaicism in spontaneous abortions revealed by interphase FISH analysis. J Histochem Cytochem 53:375–380.PubMedCrossRefGoogle Scholar
  128. Wang X, Chen C, Wang L, Chen D, Guang W, French J. Conception, early pregnancy loss, and time to clinical pregnancy: a population-based prospective study. Fertil Steril 79:577–584.Google Scholar
  129. Webster J, Chandler J, Battistutta D (1996) Pregnancy outcomes and health care use: effects of abuse. Am J Obstet Gynecol 174:760–767.PubMedCrossRefGoogle Scholar
  130. Wilcox AJ, Weinberg CR, O'Connor JF, et al. (1988) Incidence of early loss of pregnancy. N Engl J Med 319:189–194.PubMedGoogle Scholar
  131. Wolstenholme J, Rooney DE, Davison EV (1994) Confined placental mosaicism, IUGR, and adverse pregnancy outcome: a controlled retrospective U.K. collaborative survey. Prenat Diagn 14:345– 361.CrossRefGoogle Scholar
  132. World Health Organization (1970) Spontaneous and induced abortion. Technical Report Series No. 461. WHO, Geneva.Google Scholar
  133. World Health Organization (1975) International Conference on the Ninth Revision of the International Classification of Disease. WHO, Geneva.Google Scholar

Copyright information

© Springer-Verlag London Limited 2007

Authors and Affiliations

  • T. Yee Khong
    • 1
  1. 1.Department of HistopathologyWomen's and Children's HospitalNorth AdelaideAustralia

Personalised recommendations