The value of a histological examination of the products of conception after legal abortion.

Abstract

Although histologic examination of tissue from spontaneous abortions is routine in National Health Service facilities, the products of conception from induced abortion are rarely subjected to such analysis. To assess the validity of this practice, which reflects both ethical and time considerations, histologic findings in tissue removed by suction from 100 consecutive legal abortions were reviewed. In 67% of cases, both fetal and placental tissue were healthy and of the appropriate gestational age. The remaining 23 cases involved abnormal findings, including missed abortion (9%), absence of part or all of the fetus or placenta (3%), and fetus inappropriate for gestational age (11%). These results suggest that there is value in the routine performance of histologic examination after induced abortion. The potential to detect trophoblastic hyperplasia, which can progress if untreated to choriocarcinoma, is one justification for the analysis of aborted tissue. Another is the opportunity to prove, in medicolegal disputes, that an abortion was in fact completed. Histologic examination of fetal tissue is especially important in gynecological units that are not yet equipped with portable real time ultrasound machines.