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Immunohistological demonstration of intermediate trophoblast in the diagnosis of uterine versus ectopic pregnancy: a retrospective survey and results of a prospective trial
Author(s) -
SØRENSEN FLEMMING B.,
MARCUSSEN NIELS,
DAUGAARD HANS O.,
KRISTIANSEN JOHN D.,
MØLLER JAN,
INGERSLEV HANS J.
Publication year - 1991
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/j.1471-0528.1991.tb10341.x
Subject(s) - human placental lactogen , chorionic villi , gynecology , miscarriage , obstetrics , pregnancy , ectopic pregnancy , medicine , endometrium , prospective cohort study , trophoblast , placenta , biology , pathology , fetus , genetics
Summary. Immunohistological demonstration of human placental lac‐togen (hPL) in non‐villous, mononuclear intermediate trophoblastic cells may be of routine diagnostic value, when chorionic villi are absent in endometrial curettings from patients suspected of miscarriage of an intrauterine pregnancy. The histological presence and distribution of hPL was investigated in endometrial curettings from 90 patients studied retrospectively (47 had ectopic pregnancies, 14 miscarriages, and 29 legal abortions), and a consecutive, prospective series of 50 patients (40 had miscarriages and 10 had ectopic pregnancies) without chorionic villi in their endometrial curettings. Non‐specific background staining was not a problem. The retrospective survey disclosed that hPL was a highly sensitive marker of intrauterine pregnancy (sensitivity = 0.98). In the prospective series, the predictive value of positive staining for hPL for intrauterine pregnancy was 1.00, and the sensitivity of hPL, as an indicator of uterine gestation, was 0.62. In absence of specific hPL‐staining, the risk of ectopic pregnancy was about 50%. The immunohisto‐chemical demonstration of hPL is a useful tool for identifying patients who are suspected of having had a miscarriage, but for whom evidence in the form of chorionic villi in endometrial curettings is lacking.