[Sugar tolerance test in the clinical investigation of the etiology of spontaneous and habitual abortions].
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Chromosome examinations in the case of 78 married couples with recurrent abortions are discussed. The analyses were based on 141 caryogrammes--78 women, 63 men. Inheritied chromosome anomalies as cause of the recurrent abortions could be ascertained with 7 patients (5%): 4 autosomal anomalies in the form of balanced translocations; 1 gonosomal anomaly occurring as X-trisomy with deletion of the short arms of an X-chromosome; 2 cases of striking fragility of the chromosome no. 2. The significance of such chromosome anomalies in women and recurrent miscarriages is discussed. Cytogenetic and histological examinations of the aborted product of conception can give valuable indications for the detection of a chromosome anomaly in the parents. The prognosis and consequences of parental chromosome anomaly and the necessity of prenatal chromosome analyses are discussed.
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An ovariohysterectomy was done on five female cats with a history of habitual abortion in the 3rd to 4th week of pregnancy and the foetuses and placentas examined. Histologic and electron microscopic examination showed multifocal placental necrosis which was deduced to begin in the syncytial trophoblastic cells and to extend to all the cells of the labyrinth. This lesion was followed by foetal autolysis. No bacterial, viral or mycoplasmal agents could be incriminated in the disease.
Although habitual abortion occurs in a relatively small number of patients, its successful management is often difficult. Etiologic factors may be either maternal or embryonic or both; there is much information available on maternal factors but little is known of factors related to the embryo. Information obtained from examining and karyotyping the aborted embryo or fetus may be of considerable importance in determining the possible cause of the abortion and subsequent investigation and counseling of the patient. At least two specimens from over 50 women who have had two or more consecutive spontaneous abortions have been examined and the results show that: (1) Patients aborted conceptuses of the same developmental stage, i.e., embryo or fetus, in consecutive pregnancies. This suggests that investigation should be directed to factors which may be important in the stage of pregnancy indicated. (2) Late abortions were associated with normal fetal development and factors related to the uterine environment. (3) The conceptus in an early abortion was significantly more likely to have a cytogenetic abnormality, suggesting a problem at, or prior to, conception/fertilization. A case study is also included.