Differential apoptotic activity in trophoblast of spontaneous abortions and normal pregnancies.

INTRODUCTION: . Apoptosis is a key process during normal trophoblastic development and, consequently, the whole gestation. However, in trophoblastic differentiation in spontaneous abortions apoptosis has been hardly investigated. Therefore, the aim of the study was to investigate the correlation between apoptotic frequency in trophoblast and spontaneous abortion incidences. MATERIAL AND METHODS: A total of 72 trophoblastic tissue samples were immunohistochemically examined. 42 of 72 derived from first-trimester spontaneous abortions and the remaining 30 from elective terminations during the same trimester of pregnancy. TUNEL assay and M30 marker were used for apoptosis evaluation by immunohistochemistry. RESULTS: Comparative study of tissues from spontaneous abortions and elective pregnancy terminations demonstrated increased expression of both apoptotic markers in tissues derived from spontaneous abortions compared to normal pregnancies. In addition, statistical analysis correlated maternal age and gravidity with increased spontaneous abortion incidences. Moreover, both M30 and TUNEL staining were significantly correlated with maternal age and primigravidity in spontaneous abortion cases. CONCLUSIONS: Our data proved that elevated apoptotic activity during the first pregnancy trimester is clearly involved in spontaneous abortions. Moreover, two well-established apoptotic markers revealed high statistical significance in the evaluation of post-abortive tissues

Viral-induced inflammation can lead to adverse pregnancy outcomes

Introduction: Parvoviruses are DNA viruses of small size. There have been a number of reports indicating the possible effects of B19 infections during pregnancy. These effects include spontaneous abortions, stillbirth, fetal damage, and quite often, fetal anemia with hydrops fetalis. Aim: The aim of this study was the correlation of Epstein-Barr virus (EBV) and parvovirus-B19 infections with inflammation levels in placental tissue coming from spontaneous abortions and elective terminations cases. We also investigated whether viral presence could cause spontaneous abortions by associating the expression levels of inflammatory markers with adverse pregnancy outcomes. Materials and methods: One hundred ninety-four placental samples were used, 152 included in the study group coming from spontaneous abortions while 42 controls were used from cases of elective terminations. Hematoxylin and eosin (H&E) staining was performed to investigate morphological changes in the tissues, and then indirect immunohistochemistry to evaluate the expression of TNF-α, IL-6, IL-1α, B19, and EBV. Statistical analysis was performed using SPSS v. 19.0 (IBM). Results: Higher inflammation levels were observed with statistical significance in the spontaneous abortions group (p<0.001) and they were correlated with statistical significance with B19 or EBV presence (p<0.001). Viral presence was only found in the spontaneous abortions group. Both simple and multiple logistic regression confirmed that viral presence was an independent prognostic factor for high expression of all inflammatory biomarkers with statistical significance (p<0.001). Conclusions: Our results clearly indicate a specific pattern. Viral presence can deregulate inflammatory processes in the maternal-fetal environment and thus work as a trigger for spontaneous abortions