Fetal morphological features and abnormalities associated with equine early pregnancy loss

Background Early pregnancy loss (EPL) occurs in approximately 8% of equine pregnancies, although the aetiology is mostly unknown and embryonic/fetal morphological abnormalities associated with EPL are not defined. Objectives To compare the morphology of EPL to clinically normal embryos/fetuses and previously described embryonic/fetal developmental milestones. To identify morphological abnormalities associated with equine EPL. Study design Observational case‐control study. Methods Embryos/fetuses were obtained from clinically normal Thoroughbred and pony pregnancies (n = 11) and following EPL from Thoroughbred mares (n = 27). The crown‐rump length (CRL) of embryos/fetuses was measured and macroscopic morphology and developmental age were determined independently by three blinded examiners. Sagittal sections of EPL (n = 13) and control (n = 6) embryos/fetuses were assessed microscopically. Fisher's exact test was used to determine significance ( P  < .05) and correlations were expressed by Pearson coefficient. Results Age and CRL were strongly positively correlated in clinically normal Thoroughbred and reference (n = 15, R  = .9 (95% CI: 0.8‐1.0), R 2  = .9, P  < .0001) but not EPL embryos/fetuses (n = 19, R  = .1 (95% CI: −0.4 to 0.5), R 2  = .01, P  = .75). Relative to controls, the CRL of EPL embryos/fetuses was smaller, with evidence of intrauterine growth retardation (IUGR) in 3/8 fetuses assessed. In 9/13 EPL embryos/fetuses, nonspecific neural tissue alterations were identified including disruption of developing pros‐, mes‐ and rhombencephalon and the presence of haemosiderin, indicating premortem haemorrhage. Failed neural tube closure was identified in 1/13 EPL embryos/fetuses. Subcutaneous haemorrhage was present in 14/27 EPL embryos/fetuses. Main limitations Autolysis significantly affected 15/27 EPL embryos/fetuses, excluding them from complete assessment. The IUGR reference cut‐off values were based on a small number of controls. Conclusions Morphological features associated with equine EPL were a mismatch between embryonic/fetal size and age, and alterations of the developing neural tissue and localised subcutaneous haemorrhage. Failed neural tube closure was confirmed as a rare specific abnormality.