Products of conception

Author: Mikael Häggström

Comprehensiveness

On this resource, the following formatting is used for comprehensiveness:

• Minimal depth
• (Moderate depth)
• ((Comprehensive))

Gross processing

Fetal membranes versus decidua.

• Look for fetal tissue (fetus, fetal membranes or chorionic villi). If any fetal tissue is found, no lengthy search is needed for other kinds of fetal tissue, just a quick look for obvious ones. Inspect them for gross anomalies. If found, submit one piece of the fetus and one piece of the placenta.
• If fetal parts are not visually found, search for diagnostic placental tissue, which is soft and shaggy or spongy (as opposed to membranous, which is likely to be decidua or blood clots).
• If no fetal or placental tissue is found, all presented tissue needs to be submitted.

Gross report

(Labeled - products of conception.) The specimen (is received <<fresh / in formalin>>) and consists of multiple fragments of soft tan-pink decidua, blood clots and amniotic sac measuring about 5 cc in aggregate. The intact amniotic sac measures 2.3 cm in greatest dimension. Fetal tissue is identified within the amniotic sac, measuring 1.0 cm in crown-rump length. Representative sections are submitted for microscopic examination (in 1 cassette).

Microscopy

The most important is to detect the presence of chorionic villi.

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  Histopathology of products of conception, with chorionic villi (arrow) among decidualized endometrium

Microscopy report

Immature chorionic villi, having loose stroma and few capillaries.

Example:

((Products of conception/fetal tissue:)) Products of conception, including immature chorionic villi, and fetal tissue corresponding to first trimester pregnancy. ((Spontaneous abortion, clinically.))

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