Placental findings in spontaneous abortions and stillbirths

Placentae and membranes of 360 spontaneous abortions and stillbirths were studied by light microscopy and compared to 100 induced abortions of 2-5 months gestation. The placental findings were correlated with morphological and chromosomal studies of the fetuses. A high incidence of hydatid degeneration was found in early spontaneous abortions (less than 12 weeks of age), especially in "blighted ova." "Atypical" stromal cells were found in the placental villi of early abortions with trisomy and triploidy. In late spontaneous abortions (13-18 gestational weeks) inflammatory lesions of the placentae were observed in over a third of cases and the incidence of hydatid degeneration was very low. The incidence of inflammatory lesions of the placentae was further raised in cases of early fetal death (18-24 gestational weeks), involving 60% of the placentae of fetuses without malformations. In stillborn infants, over 25 weeks of age, the incidence of inflammatory placental lesions dropped again, and the incidence of vascular lesions was raised to 50%. It seems that inflammatory lesions of the placentae may play an important role in the etiology of midtrimester spontaneous abortions. Isolation of the infectious microorganism and subsequent treatment may therefore reduce the rate of fetal losses in this group.