Pathology of Chorionic Villi in Spontaneous Abortions

Abstract

Spontaneous abortions are quite common. While in a normal multiparous woman, one or two spontaneous abortions are not unusual, recurrent spontaneous abortions may pose serious problems for some couples. Many such abortions may have a background of genetic anomaly that is reflected in abnormalities of chorionic villi. It is therefore, important to study placenta for various pathological lesions in order to understand the etiology & pathogenesis of the abortion. The chorionic villi are the main fetal part and functional unit of placenta. In this study we examined various pathological changes in chorionic villi in 64 cases of spontaneous abortion specimens. These included hydropic change, numbers of vessels, patency of vessels, stromal fibrosis, fibrinoid degeneration and Hofbauer macrophages. We observed that the villi were reduced in 97% of cases, 83% of villi had stromal fibrosis, 75% displayed fibrinoid degeneration, 75% contained reduced numbers of blood vessels while the patency of vessels was seriously affected in 66% of cases, and 67% cases had prominent Hofbauer macrophages. We conclude that vast majority of spontaneous abortions have abnormal chorionic villi and the most common abnormalities are marked fibrosis and severely compromised vasculature incompatible with fetal development and viability