Etiology of spontaneous abortion before and after the demonstration of embryonic cardiac activity in women with recurrent spontaneous abortion.

OBJECTIVE: To analyze the etiologic factors of spontaneous abortion in the first trimester among women with recurrent spontaneous abortion, specifically before and after the demonstration of embryonic cardiac activity.

METHODS: A retrospective analysis included women with recurrent spontaneous abortion admitted to a center in Guangzhou, China, for dilation and curettage after a spontaneous abortion in the first trimester between January 2008 and December 2012. The etiologic factors of spontaneous abortion occurring before versus after the demonstration of cardiac activity were compared.

RESULTS: A total of 232 women were included. Among 146 women with demonstrated cardiac activity before spontaneous abortion, 78 (53.4%) had an embryonic karyotype abnormality, 55 (37.7%) had traditional etiologic factors, and 34 (23.3%) had an unidentified cause. Among 86 women without cardiac activity, 41 (47.7%) had an embryonic karyotype abnormality, 28 (32.6%) had traditional etiologic factors, and 26 (30.2%) had an unidentified cause. After exclusion of abortions involving embryonic karyotype abnormalities, there was a higher incidence of APA positivity in the group with embryonic cardiac activity than in the other group (13/68 [19.1%] vs 1/45 [2.2%]; P=0.008) and a lower incidence of subclinical hypothyroidism (8/68 [11.8%] vs 12/45 [26.7%]; P=0.042).

CONCLUSION: The distribution of etiologic factors in spontaneous abortion differs according to whether embryonic cardiac activity is recorded.