Abstract
Amaç: Abortus, 20. gebelik haftasında önce veya 500 gr.’ın altında iken gebeliğin sonlanmasıdır. Sıklığı tüm gebeliklerde %50-%70 arasındadır. Abortus materyallerinin rutin histopatolojik incelemesi konusu molar gebelik (MG) tanısı açısından tartışma konusudur. Bu çalışmadaki amacımız; kliniğimizde gerçekleşen abortusların MG sıklığının ve ön tanı başarısını değerlendirerek, histopatolojik inceleme gerekliliğini saptamaktır.
Gereç ve Yöntem: Bu retrospektif çalışmaya, 01.01.2019-01.01.2022 tarihleri arasında gebeliği abortus ile sonuçlanan, demografik verileri, USG bulguları, ön tanılarına ve histopatolojik inceleme sonuçları bulunun 1007 kadın dahil edildi. Parsiyel mol hidatiform (PMH) ve komplet mol hidatiform (KMH) tanısı olan hastaların ön tanıları ile histopatolojik inceleme sonuçları karşılaştırıldı.
Bulgular: Histopatolojik inceleme için patolojiye gönderilen materyaller arasında en sık rastlanan tanı 590 (%58.78) ile missed abortus idi. 32 (%3.17) kadında MG saptanmıştır. Bunlardan 9 (%0.89) tanesi KMH, 23 (%2.28) tanesi ise PMH olarak saptanmıştır. KMH tanısı konulan 9 hastanın 6 (%66.6) tanesinin ön tanısı KMH, PMH tanısı alan 23 hastanın 10 (%43.37) tanesinin ön tanısı PMH idi.
Sonuç: MG sıklığının %3.17 olması, ön tanı ile histopatolojik inceleme sonucu karşılaştırmasında uyumsuzluğun yüksek olması nedeni ile tüm abortus materyallerinin histopatolojik inceleme yapılmasını önermekteyiz.
References
- 1. Hoffman BL: Williams Gynecology, THIRDEDITION. Edited by McGraw-Hill Education, 2016,
- 2. Jauniaux E, Burton G: Pathophysiology of histological changes in early pregnancy loss, Placenta 2005, 26:114-123
- 3. Robinson GE: Pregnancy loss, Best practice & research Clinical obstetrics & gynaecology 2014, 28:169-178
- 4. Quenby S, Gallos ID, Dhillon-Smith RK, Podesek M, Stephenson MD, Fisher J, Brosens JJ, Brewin J, Ramhorst R, Lucas ES: Miscarriage matters: the epidemiological, physical, psychological, and economic costs of early pregnancy loss, The Lancet 2021, 397:1658-1667
- 5. Heath V, Chadwick V, Cooke I, Manek S, MacKenzie I: Should tissue from pregnancy termination and uterine evacuation routinely be examined histologically?, BJOG: An International Journal of Obstetrics & Gynaecology 2000, 107:727-730
- 6. Tantengco OAG, De Jesus II FCC, Gampoy EFS, Ornos EDB, Vidal Jr MS, Cagayan MSFS: Molar pregnancy in the last 50 years: A bibliometric analysis of global research output, Placenta 2021, 112:54-61
- 7. Genest DR: Partial hydatidiform mole: clinicopathological features, differential diagnosis, ploidy and molecular studies, and gold standards for diagnosis, International journal of gynecological pathology 2001, 20:315-322
- 8. Obstetricians ACo, Gynecologists: ACOG Practice Bulletin No. 200: early pregnancy loss, Obstetrics and Gynecology 2018, 132:e197-e207
- 9. Alsibiani SA: Value of histopathologic examination of uterine products after first-trimester miscarriage, BioMed research international 2014, 2014:
- 10. Tasci Y, Dilbaz S, Secilmis O, Dilbaz B, Ozfuttu A, Haberal A: Routine histopathologic analysis of product of conception following first‐trimester spontaneous miscarriages, Journal of Obstetrics and Gynaecology Research 2005, 31:579-582
- 11. Albayrak M, Biyik İ, Meti̇Neren M, Taşçi Y: Should all abortion materials be sent for histopathological evaluation?, Journal of Clinical Obstetrics and Gynecology 2021, 31:
- 12. Sarmadi S, Izadi-Mood N, Sanii S, Motevalli D: Inter-observer variability in the histologic criteria of diagnosis of hydatidiform moles, The Malaysian journal of pathology 2019, 41:15-24
Abstract
Aim: Abortion is the termination of pregnancy before the 20th gestational week or when the fetus is below 500 g. Its prevalence is between 50-70% in all pregnancies. Routine histological examination (HE) of abortion materials is controversial in terms of molar pregnancy (MP) diagnosis. This study aims to determine the necessity of HE by evaluating the MP frequency and pre-diagnosis success of abortions in our clinic.
Materials and Methods: In this retrospective study, 1007 women whose pregnancy resulted in abortion between 01.01.2019-01.01.2022 and whose demographic data, USG findings, pre-diagnoses and HE results were present, were included. The preliminary diagnoses of patients with CMH and PMH were compared with the HE results.
Results: Among the materials sent to pathology for HE, the most common diagnosis was missed abortion with 590 (58.78%). MP was detected in 32 (3.17%) women. Of these, 9 (0.89%) were found to be CMH, while 23 (2.28%) were PMH. While 6 (66.6%) of 9 patients diagnosed with CMD were prediagnosed with CMD, 10 (43.37%) out of 23 patients diagnosed with PMH were prediagnosed as PMH.
Conclusion: Since the prevalence of MP is 3.17% and there is a high inconsistency between the pre-diagnosis and the result of HE, we recommend that all abortion materials be performed with HE.
References
- 1. Hoffman BL: Williams Gynecology, THIRDEDITION. Edited by McGraw-Hill Education, 2016,
- 2. Jauniaux E, Burton G: Pathophysiology of histological changes in early pregnancy loss, Placenta 2005, 26:114-123
- 3. Robinson GE: Pregnancy loss, Best practice & research Clinical obstetrics & gynaecology 2014, 28:169-178
- 4. Quenby S, Gallos ID, Dhillon-Smith RK, Podesek M, Stephenson MD, Fisher J, Brosens JJ, Brewin J, Ramhorst R, Lucas ES: Miscarriage matters: the epidemiological, physical, psychological, and economic costs of early pregnancy loss, The Lancet 2021, 397:1658-1667
- 5. Heath V, Chadwick V, Cooke I, Manek S, MacKenzie I: Should tissue from pregnancy termination and uterine evacuation routinely be examined histologically?, BJOG: An International Journal of Obstetrics & Gynaecology 2000, 107:727-730
- 6. Tantengco OAG, De Jesus II FCC, Gampoy EFS, Ornos EDB, Vidal Jr MS, Cagayan MSFS: Molar pregnancy in the last 50 years: A bibliometric analysis of global research output, Placenta 2021, 112:54-61
- 7. Genest DR: Partial hydatidiform mole: clinicopathological features, differential diagnosis, ploidy and molecular studies, and gold standards for diagnosis, International journal of gynecological pathology 2001, 20:315-322
- 8. Obstetricians ACo, Gynecologists: ACOG Practice Bulletin No. 200: early pregnancy loss, Obstetrics and Gynecology 2018, 132:e197-e207
- 9. Alsibiani SA: Value of histopathologic examination of uterine products after first-trimester miscarriage, BioMed research international 2014, 2014:
- 10. Tasci Y, Dilbaz S, Secilmis O, Dilbaz B, Ozfuttu A, Haberal A: Routine histopathologic analysis of product of conception following first‐trimester spontaneous miscarriages, Journal of Obstetrics and Gynaecology Research 2005, 31:579-582
- 11. Albayrak M, Biyik İ, Meti̇Neren M, Taşçi Y: Should all abortion materials be sent for histopathological evaluation?, Journal of Clinical Obstetrics and Gynecology 2021, 31:
- 12. Sarmadi S, Izadi-Mood N, Sanii S, Motevalli D: Inter-observer variability in the histologic criteria of diagnosis of hydatidiform moles, The Malaysian journal of pathology 2019, 41:15-24
Details
| Primary Language | English |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Research Articles |
| Authors | |
| Publication Date | December 18, 2023 |
| Submission Date | October 7, 2022 |
| Published in Issue | Year 2023Volume: 62 Issue: 4 |
