Fetal loss Infectious causes , Autopsy findings

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Presentation 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 Autopsy: Complete history Macroscopy Microscopy 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