• Citer

Relationship among maternal serum endocrinology, placental karyotype, and intervillous circulation in early pregnancy failure

par Greenwold, Natalie;Jauniaux, Eric ;Gulbis, Béatrice ;Hempstock, Joanne;Gervy Decoster, Christine ;Burton, Graham J.
Référence Fertility and sterility, 79, 6, page (1373-1379)
Publication Publié, 2003-06

Article révisé par les pairs

• Accès en ligne
• Détails
• Contenu
• Statistiques

Résumé :

Objective: To evaluate the relationship among maternal serum endocrinology, placental karyotype, and intervillous blood flow in missed miscarriage. Design: Cross-sectional study of maternal serum, transvaginal ultrasound/Doppler, and placental cytogenetic and immunohistochemical investigations. Setting: Tertiary care academic hospital. Patient(s): One hundred fifty-two women with missed miscarriage between 7 and 13 weeks of gestation. Intervention(s): Ultrasound features, placental intervillous circulation findings on color Doppler imaging, and maternal serum level of alpha-fetoprotein (AFP), β-hCG, E2, P, and inhibin A were compared retrospectively with placenta karyotype and hCG immunochemistry. Main outcome measure(s): Data were analyzed according to karyotype results, presence or absence of an intervillous circulation, and delay between fetal demise and evacuation. Result(s): The presence of intervillous blood flow and serum concentrations of the different hormones were independent of placental karyotype. Serum β-hCG and P were significantly higher in cases with intervillous blood flow. No difference in immunostaining for β-hCG was found between placental tissues from normal pregnancies and missed miscarriages, but significantly higher villous β-hCG content was found on Western blotting in miscarriage with a recent fetal demise. Conclusion(s): The excessive entry of maternal blood inside the placenta in the early stage of most miscarriages is unrelated to conceptus karyotype, and hCG features may reflect a temporary attempt of the trophoblast to stabilize after the initial oxidative insult. © 2003 by American Society for Reproductive Medicine.