Histopathological changes of decidua and decidualvessels of early pregnancy


Objective: The histological examination of the decidua can provide a clue in the diagnosis of intrauterine pregnancy. The purpose of this study is to describe the morphologic features observed in the decidual blood vessels of early pregnancy loss cases prior to 20 weeks gestation, and to compare these findings with Arias-Stella reaction and with changes found in endometrial biopsies of non-pregnant women as a control group.
Material and method: A prospective case control study done at the Department of Pathology of Mosul Medical College, Histopathological Laboratories of Al-Khansa and Al-Zahrawi Teaching Hospitals and the gynecological units of Al-Khansa and Al- Batool Teaching Hospitals in Mosul.
The study was conducted on 161 reproductive aged women with different clinical types of abortion admitted for uterine evacuation. The histopathological features in the decidua and decidual vessels of curettage specimens were described, graded and compared with that observed in endometrial biopsies of non pregnant women as a control group.
Results: Out of a total 161 abortion specimens examined,10.6% of cases showed severe degree of obliterative endarteritis involving one or more decidual vessels. This finding was higher than the frequency of Arias-Stella reaction in the same specimens and none of these features were described in the control group .
Conclusion: Obliterative endarteritis of decidual vessels can be used together with other morphological features for the possibility of occurrence of a pregnancy in the absence of chorionic villi, trophoblast and other emberyonic elements.


decidua, pregnancy