Should All Abortion Materials Be Sent for Histopathological Evaluation?

Abstract

Objective: Partial hydatidiform mole is the type of mole in which a foetus and/or cardiac activity is seen. Clinical diagnosis of missed abortion and anembryonic gestation may cause the partial mole to be missed or misdiagnosed if a histopathologic examination is not carried out. Our objective in this study was to clarify whether it is really necessary to send all abortion materials for histopathological examination considering the rate of mole (complete/partial) among all abortion materials in a university hospital. Material and Methods: In this retrospective cohort study, we evaluated the clinical and histopathological results of 1,004 women with a clinical diagnosis of abortion that were diagnosed at the University of Kütahya Health Sciences Evliya Çelebi Hospital between January 2015 and December 2020. Results: Missed abortion was the most common diagnosis with 638 women (63.5%) among the abortion materials that were sent for histopathology. Complete mole was diagnosed in only one (1/1,004) woman, which was sent to pathology with a diagnosis of anembryonic gestation. The partial mole rate was 9/1,004 and most were diagnosed after a clinical diagnosis of anembryonic gestation (n=5, 55%). Placental villi were seen in 93% (934/1,004) but not in 6% (60/1,004) of the subjects (Arias-Stella reaction) on histopathology, which was possibly an ectopic pregnancy or a very early aborted early gestation in which placenta villi could not be identified. Partial and complete mole hydatidiform constituted 1% (9/1,004) and 0.1% (1,004) of the total cohort respectively. Conclusion: When taking into account the rate of mole hydatidiform (10/1,004) in a clinic where all abortion materials are being sent for histopathological examination routinely, we think that routine histopathological examination of abortion material seems reasonable and safe.