6533b834fe1ef96bd129d569

RESEARCH PRODUCT

F117Hystero-embryoscopic findings in early nonviable pregnancies

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Background A high proportion of early pregnancy losses are associated to abnormal embryo development. However, chromosomal analysis of routine curettage samples are of limited value; and histopathological examinations of the embryos are rarely performed in clinical practice. Method A transcervical hystero-embryoscopy was performed prior to the curettage in 31 nonviable first-trimester pregnancies and a control group of 5 early terminations of pregnancy. In the study group, the estimated gestational age according to the ultrasound findings was 6.7 (4–9) menstrual weeks. Direct biopsies of different gestational structures were taken during the endoscopic procedure. Results In nonviable pregnancies, focal haemorrhagic/necrotic changes were present in the decidua capsularis. The collapse of the gestational sac was variable. Most chorionic villi had an oedematous appearance. Degenerative changes of the embryo and yolk sac were not uniform. The following gestational anomalies were identified: partial moles (n = 2), structural abnormal embryos (n = 4), umbilical cord cysts (n = 3) and abnormal yolk sacs (n = 2). Chromosomal analysis of selective chorionic and embryo biopsies identified a misdiagnosis of the curettage sample result in 8 cases. Conclusion Hystero-embryoscopy offers great potential for evaluating early nonviable pregnancies. Accurate karyotypes can be obtained from direct chorionic and embryo biopsies.