Histopathologic exam of the placenta, membranes and umbilical cord - essential step in orienting the standard complex investigation of recurrent abortion

摘要

Numerous morphopathological observations of the placenta, membranes and umbilical cord detect the ascending intrauterine infection and the placental vasculopathy as being dominant in the etiopathogeny of preterm labor. When it is possible to exclude the vasculopathy early, in the asymptomatic phase of the intrauterine infection by means of precise and rapid tests, such as serum C-reactive protein dosing, it results the necessity of routinely performing the histopathologic exam of the conception product, as an essential step of orienting the standard complex investigation of the recurrent abortion. The thrombophilia defects can generate either extended placental thromboses or defects of placentation and embryonic implantation. It is thus necessary to introduce in the standardized investigation of the recurrent abortion the repeated screening for resistance to activated C protein, the molecular diagnosis for Leiden mutation of coagulation factor V, antithrombin III dosing, protein C and S concentrations, factor XII, the fibrinogen, the plasminogen, the normality of the fibrin plate lysis, congenital or acquired hyperhomocysteinaemia and to demonstrate in the laboratory the antiphospholipid antibodies that are persistent in the peripheral blood.