Profile of products of conception in early trimester spontaneous abortion: Histopathological perspective – A cross-sectional study

Introduction: The histopathological examination of Products of Conceptions (POCs) helps in understanding the etiopathogenesis of abortions, as well as detecting important pathological conditions requiring further medical attention and follow-up. The present study was designed with an aim to determine the histopathological changes in the Retained Products of Conception (RPOC) in first trimester abortions. Material and Methods: A Cross-Sectional Study was conducted from November 2016 to October 2018 in the Department of Pathology of a tertiary care hospital in Maharashtra. Around 150 specimens labelled as product of conception in the first-trimester (up to 12 weeks) following a spontaneous abortion were included in the study. The data was analyzed using Epi Info version 7.2. The qualitative data was expressed using percentages and proportions and quantitative data as mean and standard deviation. Results: Of the 118 specimens, inflammation was present in 16.95%, fibrotic changes in 33.90%, Hydropic changes in 30.51% and 5.93% had molar changes. We found decidua in 95.33% cases. Of which, 55.94% showed inflammation, 20.28% showed edema, 82.52% showed hemorrhage, 65.73% showed congested vessels, 10.49% showed necrosis, 23.78% showed fibrin deposition, 12.59% showed degenerative changes. Out of 150 cases, 121 cases were diagnosed as RPOC. Nearly 40% of the cases were of infected RPOC, 11 cases were of tubal ectopic pregnancy, 6 cases were diagnosed as partial vesicular mole and one case of each of heterotopic pregnancy, cervical ectopic pregnancy, ovarian ectopic pregnancy, complete vesicular mole, and choriocarcinoma. Conclusion: Inflammation, hydrops, and fibrosis were the common gross pathology findings with histopathology showing hemorrhage, vascular congestion, and inflammation.