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Fertil Steril. 2003 Jun;79(6):1373-9.

Relationship among maternal serum endocrinology, placental karyotype, and intervillous circulation in early pregnancy failure.

Author information

1
Academic Department of Obstetrics and Gynaecology, Royal Free and University College London Medical School, UCL Campus, London, United Kingdom.

Abstract

OBJECTIVE:

To evaluate the relationship among maternal serum endocrinology, placental karyotype, and intervillous blood flow in missed miscarriage.

DESIGN:

Cross-sectional study of maternal serum, transvaginal ultrasound/Doppler, and placental cytogenetic and immunohistochemical investigations.

SETTING:

Tertiary care academic hospital.

PATIENT(S):

One hundred fifty-two women with missed miscarriage between 7 and 13 weeks of gestation.

INTERVENTION(S):

Ultrasound features, placental intervillous circulation findings on color Doppler imaging, and maternal serum level of alpha-fetoprotein (AFP), beta-hCG, E(2), P, and inhibin A were compared retrospectively with placenta karyotype and hCG immunochemistry.

MAIN OUTCOME MEASURES:

Data were analyzed according to karyotype results, presence or absence of an intervillous circulation, and delay between fetal demise and evacuation.

RESULT(S):

The presence of intervillous blood flow and serum concentrations of the different hormones were independent of placental karyotype. Serum beta-hCG and P were significantly higher in cases with intervillous blood flow. No difference in immunostaining for beta-hCG was found between placental tissues from normal pregnancies and missed miscarriages, but significantly higher villous beta-hCG content was found on Western blotting in miscarriage with a recent fetal demise.

CONCLUSION(S):

The excessive entry of maternal blood inside the placenta in the early stage of most miscarriages is unrelated to conceptus karyotype, and hCG features may reflect a temporary attempt of the trophoblast to stabilize after the initial oxidative insult.

PMID:
12798885
DOI:
10.1016/s0015-0282(03)00364-9
[Indexed for MEDLINE]

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