Circulating Antisperm Antibody (ASA) in Women is not Associated with Missed Abortions at the First-trimester Pregnancy

Objective To determine the role of the circulating antisperm antibody （ASA） in the pathogenesis of missed abortion at the first-trimester pregnancy. Methods Sixty-two patients with a history of missed abortion at the first-trimester pregnancy were enrolled into this study. Indirect immunobead test （IBT） was used to measure the circulating ASA levels. Fifty healthy women with the first-trimester pregnancy set as the control. Results No case had the positive level of ASA according to the World Health Organization criteria （50% or more of the motile sperm with immunobead binding）. Only 1 case in patient group and 1 case in the control had 10%-20% of the motile spermatozoa with ASA-IgG bead binding. In both patient and control groups, ASA-IgA was found to be completely negative binding. Conclusion The circulating ASA is not associated with the pathogenesis of missed abortions at the first-trimester pregnancy.

Expression and Influence of Galectin-3 on Missed Abortion

Objective To explore the influence of galectin-3 on missed abortion. Methods Forty cases of normal intrauterine early pregnancy were randomly divided into 2 groups： surgical abortion group （group A, n=20） and medical abortion group （group B, n =20）. The third group was missed abortion group （group C, n =20） with the gestational age less than 13 weeks. Serum was isolated from the blood samples, collected and used for ELISA quantification of galectin-3. Villus and decidua tissues were collected from the abortus for immunohistochemical examination and real-time fluorescence relative quantitative PCR. Results The level of galectin-3 in the serum was the lowest in missed abortion group （P〈0.05）. Immunohistochemistry showed that galectin-3 expression in villus of missed abortion group was significantly lower than that of surgical abortion group （P〈0. 01）. Real-time fluorescence relative quantitative PCR showed that galectin-3 mRNA relative expression in villus of missed abortion group （2^-△△Ct=0. 04± 0. 01） was significantly lower than that of surgical abortion group （2^-△△Ct=1.00 ± 0.00）. Galectin-3 mRNA relative expression in deciduas of medical abortion group （2-zact=o. 08 ± 0.02） was s!gnificantly lower than that of surgical abortion group （2^-△△Ct=1.00 ± 0.00） （P〈0. 01）. Conclusion Galectin-3 is related to the development of villus and decidua during early pregnancy. The decreased expression of galectin-3 may promote the occurrence of missed abortion.

Analysis of Clinicopathologic Classification Features of Hydatidiform Mole Misdiagnosed as Missed Abortion Preoperatively

Objective:To analyze clinicopathologic classification features of the cases that were diagnosed as missed abortion preoperatively but turn out to be hydatidiform mole(HM)postoperatively.Methods:A retrospective analysis was conducted on the patients who had a missed abortion in our hospital from 2017 to 2018.Clinical and pathological characteristics of different types of HMs were observed.Diagnostic value of karyotype in HM was discussed based on the karyotype analysis of villi chromosome.Results:A total of 278(11.2%)HM patients were misdiagnosed as missed abortion.Naked-eye detection rate of HM was 26.61%,and sensitivity of transvaginal ultrasound on HM was 7.91%.One hundred and forty-seven(52.88%)HM cases could not be genotyped via pathological hematoxylin and eosin(HE)staining.70 HM patients underwent P57 immunohistochemistry,which had guiding significance to the classification.In addition,the karyotype diagnosis of the tissues from 15 cases basically matched their P57 classifications.Conclusions:P57 should be listed as a routine test in hydatidiform pathological examination at the same time of HE staining,and what’s more,P57 expression is consistent with genotyping,which should be recommended for the patients with HM if observed by naked eye.

Termination of Missed Abortion in A Combined Procedure: A Randomized Controlled Trial

Objective To access an ideal procedure terminating missed abortion within 12 weeks of gestational age. Methods Women with intrauterine fetal death were randomized into 3 groups. Group A （n=30）： vaginal misoprostol （MP） 0.4 mg, 3 h before vacuum aspiration; group B（n=15）： vaginal MP 0.4 mg every 3 h, up to 5 doses; group C（n=30）： oral mifepristone （MF） 200 mg 36-48 h before vaginal MP 0.4 mg, MP was given every 3 h, up to 5 doses. Results Women in group A had the shortest interval of gestation tissue expulsion （3.2± 0.5 h） and the bleeding （3.2 ± 5.7 ml） during medical procedure, which were statistically significant in comparison with the other two groups （P〈0.001, P〈0.01, respectively）. Success rates of groups A, B and C were 100%, 33.3% and 90.0%, respectively. Percentages of women need surgical interventions were similar in group B and group C（80.0%,76.7%, respectively）. Bleeding during operation, pain after medical procedure and satisfaction presented no statistical significance among the 3 groups. Conclusion Vaginal MP followed by vacuum aspiration was valuable in safety, and efficacy, which led to less bleeding and a faster recovery.