Download Fetal loss Infectious causes , Autopsy findings

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Transcript
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



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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