Finding Answers
When A Pregnancy Is Lost
How a Perinatal Pathologist Can Help

If you have suffered the loss of a pregnancy, you know any threat to the well-being of a pregnancy and the child it represents is one of the most fearful and significant experiences of life.

In recommending a consultation with a perinatal pathologist, your physician seeks to expand their and your own understanding of why problems occurred in your pregnancy.

A careful evaluation of tissues from a lost pregnancy has the capacity to address both the emotional and biological aspects of pregnancy loss. The studies provide crucial insights into both "what was normal" and "what was abnormal" about a failed pregnancy.

Using this knowledge, your physician will help you find the best possible answers to the vital question, "Why was my pregnancy lost?"

Appropriate changes in evaluation, treatment, and monitoring can be introduced in future pregnancies to maximaize the chances for healthy childbirth.

How do changes in pregnancy make the body vulnerable?

In a successful pregnancy, the body must extensively "remodel" uterine blood vessels in order to accomodate the increased blood flow necessary to feed the growing fetus.

Normally, the body would call up an army of immune responses intended to block such tissue remodeling. The pregnancy, however, is a unique time when special rules apply, but only in the uterus.

During a normal pregnancy, in ways that are not fully understood, the immune system communicated with the developing placenta to allow needed blood vessel growth and to prevent rejection of the fetus and the placenta.

Other parts of the body maintain normal blood vessels and immune status during pregnancy.

What might the pathology studies show?

Many of the common laboratory tests used to evaluate pregnancy loss attempt to identify suspect changes in the body's immune arsenal. Since during pregnancy circulating blood defenses remain unchanged, such tests may miss a serious problem. Other tests may identify a marker of a general problem, but not tell us all we need to know.

Tissues, which are the targets of either blood vessel or immune injury, can provide additional and potentially critical information. By examining them carefully under a powerful microscope, a specially-trained pathologist can determine if a problem exists and what type of disease process may be harming the uterine blood vessels. Some of these processes have been found to be recurrent, and their existence may have implications for your next pregnancy.

The most common types of problems in uterine blood vessels are failure to be remodeled by pregnancy; thrombosis (abnormal clotting on the placental surface); and chronic inflammation, "balance" between your immune system and placenta may not have been maintained.

How to Arrange a Consultation

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