Cytogenetic analysis of 355 cases of fetal loss in different trimesters

Abstract

We estimated the success rates of cytogenetic analyses in different tissue samples after intrauterine fetal deaths and analyzed the value of cytogenetic testing for determining the causes. Women with intrauterine fetal deaths (occurring at > 10 weeks of gestation) were offered either invasive testing before medical induction of labor, or solid tissue biopsy diagnosis after delivery. A total cohort of 355 intrauterine fetal deaths was studied. During antepartum examinations, invasive procedures included amniocentesis (AMC), chorionic villus sampling (CVS) and umbilical cord (UBC) sampling. During postpartum examinations, samples were taken from unfixed specimens of fetal skin, placenta and other tissues. Chromosomal abnormalities were observed in 22 fetal deaths for which cytogenetic analyses were successful. Logistic regression analysis identified antepartum invasive sampling [P = 0.000, odds ratio (OR) 31.125, 95% confidence interval (CI) 14.265-67.908] to be associated with a high cytogenetic success rate and older age with fetal deaths (P = 0.104, OR 0.487, 95% CI 0.204-1.160) not to be associated with a high chromosomal abnormality. In the patients with recurrent pregnancy loss, the chromosomal abnormality rate of 18.6% of spontaneous abortions has not been significantly more than that of fetal deaths 11.5% (P = 0.437). Parents should be counseled on all aspects of cytogenetic analysis after fetal death. Antepartum testing after pregnancy loss is recommended.