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Pathology - Spontaneous Abortion
This patient may clinically diagnosed with threatened abortion . Her indications and symptoms may suggest that there is impending spontaneous abortion (miscarriage), which follows from fetal demise in utero . Approximately 80% of spontaneous abortions occur with the first 12 weeks. Miscarriage is generally linked with bleeding into the decidual membrane and local tissue necrosis. The typical natural process that follows is detachment of the ovum/fetus from the endometrium, which drives uterine contraction and expulsion of the products of conception. Approximately 30% of all pregnancies are lost after implantation has occurred, with two-thirds of these being clinically silent, prior to diagnosis of a pregnancy. Most usually there is a fetal chromosomal defect and in half of the cases there is a “ blighted ovum ” (missing fetus). Chromosomal mistakes become less likely when loss happens later in pregnancy.
Risk factors include maternal age, type 1 DM, progesterone shortage, and hypothyroidism, with weak associations to smoking, alcohol, diet, and environmental pollutants; infections are an uncommon cause of miscarriage. Uterine anomalies including fibroids in the endometrial area or other anatomical uterine defects may have a role. The condition of incompetent cervix resulting in protrusion of membranes into the vagina may be a symptom of later miscarriage and is surgically treated with cerclage. Recurrent miscarriage is defined if three or more consecutive pregnancy losses before 20 weeks occur. Autoimmune or alloimmune (against another person) variables may be implicated.
This patient may clinically diagnosed with threatened abortion . Her indications and symptoms may suggest that there is impending spontaneous abortion (miscarriage), which follows from fetal demise in utero . Approximately 80% of spontaneous abortions occur with the first 12 weeks. Miscarriage is generally linked with bleeding into the decidual membrane and local tissue necrosis. The typical natural process that follows is detachment of the ovum/fetus from the endometrium, which drives uterine contraction and expulsion of the products of conception. Approximately 30% of all pregnancies are lost after implantation has occurred, with two-thirds of these being clinically silent, prior to diagnosis of a pregnancy. Most usually there is a fetal chromosomal defect and in half of the cases there is a “ blighted ovum ” (missing fetus). Chromosomal mistakes become less likely when loss happens later in pregnancy.
Risk factors include maternal age, type 1 DM, progesterone shortage, and hypothyroidism, with weak associations to smoking, alcohol, diet, and environmental pollutants; infections are an uncommon cause of miscarriage. Uterine anomalies including fibroids in the endometrial area or other anatomical uterine defects may have a role. The condition of incompetent cervix resulting in protrusion of membranes into the vagina may be a symptom of later miscarriage and is surgically treated with cerclage. Recurrent miscarriage is defined if three or more consecutive pregnancy losses before 20 weeks occur. Autoimmune or alloimmune (against another person) variables may be implicated.
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