Introduction: Abortion is defined as the ending of a pregnancy before 20 weeks
of gestation or the delivery of a fetus that weighs less than 500 grams.
Histopathological examination of the products of conception (POC) can
diagnose the underlying cause of abortion e.g., molar pregnancy and
hydropic alterations. Methodology: Over a period of five years, from 2017 to
2022; a total number of 569 cases of first-trimester abortion curetted material
were sent to the regional laboratory, Department of Histopathology, Al-
Qunfudah, Saudi Arabia. Clinical data of each case, type of abortion,
placental morphology, villus size, villus vascularity and histopathological
findings of each POC sample were studied. Results: The mean age of the
studied women was (32.74 ± 7.04 years), with a mean number of pregnancies
of 4.68 ± 3.07 (range: 0 - 25). Out of the studied POC samples n=355 (62.4%)
were incomplete abortions, while inevitable abortion was the least frequent
type n=15 (2.7%). There was a significant relationship between fibrin, Arias-
Stella, hydrophobic changes, and fibrosis with villus size (p= 0.005, 0.001,
0.001, and 0.013, respectively). Additionally, villus vascularity was
significantly associated with the histopathology findings; fibrin, fibrosis,
Arias-Stella, and hydrophobic changes (p= 0.001, 0.005, 0.001, and 0.001,
respectively). Conclusion: Our findings support that most abortions might be
due to chromosomal abnormalities suggested by the significant prevalence of
small and hypo-vascularized villi in the studied POC. Routine
histopathological examination of all POC is mandatory to rule out critical
conditions such as molar or ectopic pregnancy.
Keywords: Histopathology, abortion, product of conception, villus size, villus
vascularity, Saudi Arabia
