Fetal loss Infectious causes , Autopsy findings
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Transcript Fetal loss Infectious causes , Autopsy findings
Dr. S.B.Mohseni moghaddam
Clinical and surgical pathologist
Parseh pathobiology and genetics lab.
Infectious agents
Early pregnancy loss:
Uncommon cause of early pregnancy loss
mumps , measles , CMV , parvovirus B-19
Mycoplasma hominis , ureaplasma u.
Syphilis ,brucella abortus, salmonella T. , vibrio
Chlamydia trachomatis
Toxoplasma gondii
Rubella and varicella
Late pregnancy loss:
Maternal- fetal infection is associated with pregnancy loss
in 2`nd or 3`rd trimesters.
73% positive chorioamnion culture in spontaneous delivery
prior to 30 w.
21% positive culture in clinically indicated delivery perior to
30 w.
Bacterial vaginosis: two fold increase risk of spontaneous
preterm birth.
P. Loss 2 fold increased in high level BV against low level
chronic Endometritis
An important cause of RPL especially unexplained RPL
360 case with unexplained RPL:
208 (57.8%) signs of CE in hysteroscopy which 91.3%
of them had positive histology and 68.3% had positive
culture.
25.3% mycoplasma & ureaplasma and 77.5% common
bacterias
71% of known CE treated by Ab. Which 78.4% of them
had live birth after one year.
Product of conception
Before 12 – 14 w : simple pathologic evaluation
After 14 w : autopsy
Autopsy:
Complete history
Macroscopy
Microscopy
Which fetuses?
What is the specimen?
How can we submit the specimen?
Placental membranes
placental infarctions