Abstract
High incidence of missed abortion induces to search for its causes. Apart from genetic and anatomic uterine factors, the state of the decidual endometrium and implantation zone of chorionic structures of the gestational sac are of particular interest. Direct visualization of the intact decidual endometrium is possible with embryoscopy, however, there is lack of presented data of normal and pathological signs of the endometrium during pregnancy. This paper describes the changes of the endometrium in missed abortion obtained by hysteroscopy in 160 women with nonprogressive pregnancy after ART protocols. High incidence of vascular disorders is determined, namely perivascular hemorrhage (70%), thrombosis of small-caliber endometrial vessels (36.9%), necrosis of the decidual endometrium and areas of the endometrium ejection beyond the implantation zone as a source of vaginal bleeding (10%). In addition, a high incidence of capsular decidual membrane defects are detected, namely, dystrophy, thinning and necrosis (60.6%).
Highlights
Miscarriage occurs in approximately one-third of pregnant women [1]
Apart from genetic and anatomic uterine factors, the state of the decidual endometrium and implantation zone of chorionic structures of the gestational sac are of particular interest
This paper describes the changes of the endometrium in missed abortion obtained by hysteroscopy in 160 women with nonprogressive pregnancy after ART protocols
Summary
Miscarriage occurs in approximately one-third of pregnant women [1] It affects greatly the quality of life of a woman who got pregnant after long-term expectation and especially as a result of IVF program. The state of endometrium and implantation of the embryo during the IVF cycle cannot be adequately evaluated with noninvasive methods, while endometrial biopsy followed by histological assessment is a risk. We can obtain some information about causes of pregnancy loss using an ultrasound examination, histology of aspirated intrauterine tissue and chorionic villi sampling and karyotyping. The information about normal and pathological hysteroscopic signs of the endometrium in pregnancy is underexplored
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