[Study of histopathology of endometrium following termination of early pregnancy using mifepristone]

To explore the causes of abnormal uterine bleeding following termination of early pregnancy using mifepristone.

19 specimens were obtained by curettage on the day immediately after expulsion of gestational sac, 40 specimens on the 7th postabortal day and 20 specimens during 2-12 weeks after induced abortion using mifepristone respectively. The histopathologic changes of the specimens were observed by HE staining, and the expression of human choronic gonadotropin (hCG) and human placental lactogen (hPL) by immunohistochemical studies as well as phloxine-tartrazine staining and Gordon Sweets staining.

It showed that decidua shedding retarded, especially basal decidua. Immunohistochemical studies demonstrated the trophoblasts were still active and might affect pathological changes of local endometrium. The specific granules of endometrial granulocytes disappeared, together with disintegration of the reticular fibers. But in the group which curettage was indicated for abnormal bleeding 2 weeks after abortion, the main cause was incomplete abortion.

In addition to incomplete abortion, the retardation of decidua shedding and the impairment of endometrium regeneration were responsible for the abnormal uterine bleeding following termination of early pregnancy using mifepristone. The incomplete dissolution of the reticular fibers in basal decidua may induce decidua shedding retardation and incomplete abortion.