Fetal Pathology in Spontaneous Abortion

Abstract

Pregnancy is a truly remarkable process. While a single fertilised cell is developing into a complete individual, the mother usually tolerates this rapidly growing "transplant", her enlarging uterus and the accompanying dramatic hormonal changes with equanimity. Perhaps it is hardly surprising that such a complex process sometimes fails.

Changing times have influenced the degree of importance society attaches to fetal and perinatal loss. It is not very long since recurrent pregnancy, high infant mortality and stillbirth were accepted with resignation, as normal hazards of living. However with effective contraception, careful obstetric supervision and the improvements in nutrition, hygiene and health which have come to affluent western societies, the present expectation is of a chosen number of pregnancies, precisely timed and with perfect outcome. Yet about one in ten couples is infertile; nearly one in five recognised pregnancies ends in spontaneous abortion (1) and an even greater number of unrecognised early pregnancies are aborted (2). Fetal loss is still a common problem.