Decidual and placental histologic findings in patients experiencing spontaneous abortions in relation to pregnancy order

Am J Reprod Immunol. 1997 Mar;37(3):257-61. doi: 10.1111/j.1600-0897.1997.tb00224.x.


Problem: In investigating possible immunologic causes of miscarriage, we hypothesized a more frequent maternal immune response in placental tissue in women miscarrying their first pregnancy, compared to woman miscarrying following at least one full-term delivery.

Method of study: We reviewed the medical charts of 273 consecutive women who had treatment for miscarriage. After application of the exclusion criteria, 32 patients were selected who had a full-term pregnancy outcome following the index miscarriage. The patients were divided into two groups based on the pregnancy order of the index miscarriage. Group 1 (n = 16) included women who lost their first pregnancy. Group 2 (n = 16) included women who miscarried a pregnancy after at least one full-term delivery. Miscarriage tissue was evaluated for placental and decidual histologic features of uteroplacental vasculopathy and chronic inflammation.

Results: Lesions of chronic inflammatory and uteroplacental vasculopathy were generally more common in Group 1 as compared to Group 2, and the presence of more than one of the histopathologic lesions was significantly more frequent in Group 1 (37.5%, 6/16) than in Group 2 (0/16, P = .02, Fisher's Exact).

Conclusions: This study demonstrates more frequent lesions of chronic inflammation and uteroplacental vasculopathy in miscarriage patients with a first pregnancy loss, compared to those patients who have had a pregnancy loss following at least one full-term delivery.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Abortion, Spontaneous / pathology*
  • Adult
  • Birth Order*
  • Chronic Disease
  • Decidua / pathology*
  • Female
  • Humans
  • Inflammation / pathology
  • Placenta / pathology*
  • Pregnancy
  • Pregnancy Complications, Cardiovascular / pathology
  • Retrospective Studies
  • Single-Blind Method