Abstract
Pregnancy loss is a very frequent phenomenon. At least 30% of pregnancies recognized on the basis of human chorionic gonadotropin (hCG) assays are lost, often prior to clinical recognition of pregnancy. Genetic factors are responsible for most losses in clinically recognized pregnancies, and probably also for most losses before clinical recognition. In this chapter we consider first the frequency and timing of pregnancy loss and then enumerate known genetic causes. Specific consideration of the role of non-genetic factors in pregnancy loss is discussed in Chapter 6.
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References
Simpson JL, Carson SA. Causes of fetal loss. In: Gray R, Leridon H, Spira F, eds. Proceedings of seminar on biological and demographic determinants of human reproduction. Oxford: Oxford Press; in press.
Carson SA, Simpson JL. Spontaneous abortion. In: Eden RD, Boehm RH, eds. Fetal assessment: Physiological, clinical, and medio-legal principles: Ease Norwalk, CT: Appleton-Century-Crofts; 1989: 559–574.
Simpson JL. Aetiology of pregnancy failure. In: Chapman. MC, Grudzinkas JF, Chard T, eds. Endocrinology and metabolism in human reproduction. London: Springer-Verlag; pp. 11–35, 1991.
Simpson JL, Carson SA. Genetic and nongen-etic causes of fetal wastage. In: Sciarra JJ, ed. Gynecology and obstetrics. New York: Harper Row; volume 5, chapter 90, 1992.
Simpson JL. Fetal wastage. In: Gabbe SA, Niebyl JF, Simpson JL, eds. Obstetrics: normal and problem pregnancies. 2nd ed. New York: Churchill-Livingstone; 1991; 783–807.
Simpson JL. Genetics of fetal losses. In: Simpson JL, Golbus MS, eds. Genetics in obstetrics and gynecology. 2nd ed. Philadelphia, W.S. Saunders; in press.
Miller JF, Williamson E, Glue J, et al. Fetal loss after implantation: A prospective study. Lancet. 1980;2:554–556.
Edmonds DK, Lindsay KS, Miller JR, et al. Early embryonic mortality in women. Fertil Steril. 1982;38:447–553.
Whittaker PG, Taylor A, Lind T. Unsuspected pregnancy loss in healthy women. Lancet. 1983; 1:1126–1127.
Wilcox AJ, Weinberg CR, O’Connor JF, et al. Incidence of early loss of pregnancy. N Engl J Med. 1988;319:189–194.
Mills JL, Simpson, JL, Driscoll SG, et al. Incidence of spontaneous abortion among normal women and insulin-dependent diabetic women whose pregnancies were identified within 21 days of conception. N Engl J Med. 1988; 319:1617–1623.
Guzick DS, Wilkes C, Jones HW Jr. Cumulative pregnancy rates for in vitro fertilization. Fertil Steril. 1986;46:663–667.
Buster JE, Bustillo M, Rodi IA, et al. Biologic and morphologic development of donated human ova recovered by nonsurgical uterine lavage. Am J Obstet Gynecol 1985;153:211–217.
Formiglio L, Formiglio G, Roccio C Donation of fertilized uterine ova to infertile women. Fertil Steril. 1987;47.162–165.
Stevenson AC, Dudgeon MY, McClure HI. Observations on the results of pregnancies in women resident in Belfast. II. Abortions, hyda-tidiform moles and ectopic pregnancies. Ann Hum Genet. 1959;23:395–411.
Christiaens GCML, Stoutenbeek PH. Spontaneous abortion in proven intact pregnancies. Lancet. 1984;2:572.
Wilson RD, Kendrick V, Wittman BK, et al. Risk of spontaneous abortion in ultrasonog-raphically normal pregnancies. Lancet. 1984; 2:920.
Gilmore DH, McNay MB. Spontaneous fetal loss rate in early pregnancy. Lancet. 1985; 1:107.
Cashner KA, Christopher CR, Dysert GA. Spontaneous fetal loss after demonstration of a live fetus in the first trimester. Obstet Gynecol. 1987;70:827–830.
Simpson JL, Mills JL, Holmes LB, et al. Low fetal loss rates after ultrasound-proved viability in early pregnancy. JAMA. 1987;258:2555–2557.
Leridon H. Human fertility: The basic components. Chicago: University of Chicago Press; 1977.
Tabor A, Philip J, Madsen M, et al. Randomized controlled trial of genetic amniocentesis in 4606 low-risk women. Lancet. 1986;1:1287–1293.
Working Party on Amniocentesis. An assessment of the hazards of amniocentesis. Report to the Medical Research Council by their Working Party on Amniocentesis. Br J Obstet Gynecol. 1978;85(suppl2):l-41.
Hertig AT, Rock J, Adams EC. Description of human ova within the first 17 days of development. Am J Anat. 1956;98:435–493.
Hertig AT, Rock J, Adams EC, Menkin MC. Thirty-four fertilized human ova, good, bad and indifferent, recovered from 210 women of known fertility. A study of biologic wastage in early human pregnancy. Pediatrics. 1959;25: 202–211.
Hertig AT, Rock J. Searching for early human ova. Gynecol Invest. 1973;4:121–139.
Angell RR, Aitken RJ, Van-Look PFA, et al. Chromosome abnormalities in human embryos after in vitro fertilization. Nature. 1983;303: 336–338.
Rudak E, Dor J, Mashiach S, et al. Chromosome analysis of human oocytes and embryos fertilized in vitro. Ann NY Acad Sci. 1985; 442:476.
Zenzes MT, Belkien L, Bordt J, et al. Cytologic investigation of human in vitro fertilization failures. Fertil Steril. 1985;43:883–891.
Angell RR, Templeton AA, Aitken RJ. Chromosome studies in human in vitro fertilization. Hum Genet. 1986;72:333–339.
Michelmman HW, Bonhoff A, Mettler L. Chromosome analysis in polyploid human embryos. Hum Reprod. 1986;1:243–246.
Plachot M, Junca AM, Mandelbaum J, et al. Chromosome investigations in early life. II. Human preimplantation embryos. Hum Reprod. 1987;2:29–35.
Papadopoulos G, Templeton AA, Fisk N, et al. The frequency of chromosome anomalies in human preimplantation embryos after in vitro fertilization. Hum Reprod. 1989;4:91–98.
Plachot M. Genetics of human oocytes. In: Proceedings, XII Congress, International Federation of Fertility Societies, Marrakesh, Morocco, 1989. Parthenon Press; volume 6, pp. 31–39, 1991.
Gropp A. Fetal mortality due to aneuploidy and irregular meiotic segregation in the mouse. In: Boue A, Thibault C, eds. Les accidents chromo-siques de la reproduction. Paris: NSERM, 1973:225–268.
Gropp A. Chromosomal animal model of human disease. Fetal trisomy and development failure. In: Berry L, Poswillo DE, eds. Teratology. Berlin: Springer-Verlag; 1975:17–35.
Watt JL, Templeton AA, Messinis I, et al. Trisomy 1 in an eight cell human pre-embryo. J Med Genet. 1987;24:60–64.
Boue J, Philippe E, Giroud A, et al. Phenotypic expression of lethal chromosomal anomalies in human abortuses. Teratology. 1976;14:3–20.
Jacobs PA, Angell RR, Buchanan IM, et al. The origin of human triploids. Ann Hum Genet. 1978;42:49–57.
Simpson JL. Disorders of sex differentiation: Etiology and clinical delineation. New York: Academic Press; 1976.
Chandley AC. The origin of chromosome aberrations in man and their potential for survival and reproduction in the adult human populations. Ann Genet. 1981;24:5–11.
Simpson JL, LeBeau MM. Gonadal and statural determinants on the X chromosome and their relationship to in vitro studies showing prolonged cell cycles in 45,X; 46,X,del(X)(pll); 46,X,del(X)(ql3) and (q22) fibroblasts. Am J Obstet Gynecol. 1981;141:930–939.
Guerneri S, Bettio D, Simoni G, et al. Prevalence and distribution of chromosome abnormalities in a sample of first trimester internal abortions. Hum Reprod. 1987;2:735–739.
Boue J, Boue A, Lazar P. Retrospective and prospective epidemiological studies of 1500 karyotyped spontaneous human abortions. Teratology. 1975;12:11–26.
Ledbetter DH, Martin АО, Verlinsky Y, et al. Cytogenetic results of chorionic villus sampling: High success rate and diagnostic accuracy in the United States collaborative study. Am J Obstet Gynecol. 1990;162:495–501.
Tharapel AT, Elias S, Shulman LP, et al. Re-sorbed co-twin as an explanation for discrepant chorionic villus results: Non-mosaic 47, XX + 16 in villi (direct and culture) with normal (46,XX) amniotic fluid and neonatal blood. Prenat Diagn. 1989;9:467–476.
Ruzicska P, Cziezel A. Cytogenetic studies on midtrimester abortuses. Humangenetik. 1971; 10:273–297.
Warburton D, Kline J, Stein Z, et al. Cytogenetic abnormalities in spontaneous abortion of recognized conceptions. In: Porter IH, Hatcher NH, Willey AM, eds. Perinatal genetics: Diagnosis and treatment. Orlando, Fla: Academic Press, 1986;23–40.
Bauld R, Sutherland CR, Bain AD. Chromosome studies in investigation of stillbirths and neonatal deaths. Arch Dis Child. 1974;49:782–788.
Kuleshov NP. Chromosome anomalies of infants dying during the perinatal period and premature newborn. Hum Genet. 1976;34:151–160.
MacLeod PM, Dill F, Hardwick DF. Chromosomes, syndromes and perinatal deaths: The genetic counselling value of making a diagnosis in a malformed abortus, stillborn, and deceased newborn. Birth Defects. 1979;15(A5):105–111.
Hassold T. A cytogenetic study of repeated spontaneous abortions. Am J Hum Genet. 1980;32:723–730.
Warburton D, Kline J, Stein Z, et al. Does the karyotype of a spontaneous abortion predict the karyotype of a subsequent abortion? Evidence from 273 women with two karyotyped spontaneous abortious? Am J Hum Genet. 1987; 41:465–483.
Alfi OS, Chang R, Azen SP. Evidence for genetic control of non-disjunction in man. Am J Hum Genet. 1980;32:477–483.
Alberman ED. The abortus as a predictor of future trisomy 21. In: de la Cruz FF, Cerald PS, eds. Trisomy 21 (Down’s syndrome). Baltimore: University Park Press; 1981;69.
Simpson JL, Meyers CM, Martin AO, et al. Translocations are infrequent among couples having repeated spontaneous abortions but no other abnormal pregnancies. Fertil Steril. 1989;51:811–814.
Simpson JL, Elias S, Martin AO. Parental chromosomal rearrangements associated with repetitive spontaneous abortions. Fertil Steril. 1981;36:584–590.
Daniels A, Hook EB, Wulf G. Risks of unbalanced progeny at amniocentesis to carriers of chromosome rearrangements: Data from United States and Canadian laboratories. Am J Med Genet. 1989;31:14–53.
Martin AO, Simpson JL, Deddish RB, et al. Clinical implications of chromosomal inversions. A pericentric inversion in No. 18 segregating in a family ascertained through an abnormal proband. Am J Perinatol. 1983;1:81–88.
Sutherland GR, Gardiner AJ, Carter RF. Familial pericentric inversion of chromosome 19 inv(19) (pl3ql3) with a note on genetic counseling of pericentric inversion carriers. Clin Genet. 1976;10:53–59.
Rao PSS. Reproduction in isolated human population and effects of consanguinity. In: Teoh E, Ratnam SS, Goh VHH, eds. Releasing hormones and genetics and immunology in human reproduction. Parthenon; 1987; 153–163.
Schacter B, Weitkamp LR, Johnson WE. Paternal HLA compatibility in fetal wastage, and neural tube defects. Evidence for T/t-like locus in humans. Am J Hum Genet. 1984;36:1082–1085.
Nishimura H, Takano K, Tanimura T, et al. Normal and abnormal development of human embryos: First report of the analysis of 1213 intact embryos. Teratology. 1968;1:281–290.
Opitz JM. Prenatal and perinatal death: The future of development pathology. Pediat Pathol. 1987;7:363–394.
Cordier MP, Sournies G, Domenichini, et al. Bilan de 100 autopsies pratiquees dans le service de maternite de l’Hotel-Dieu de Lyone sur une periode de 18 mois. J Genet Hum. 1985;33:295–300.
Dechelotte P, Malpuech G, Jacquetin B, et al. Apport de la vertification anatomique du foetus et du aouveau-ne pour le diagnostic et le consiel genetique. A propos de 221 autopsies. J Genet Hum. 1985;33:283–288.
Pierquin G, Dodinval P. L’autopsie foetale ou neonatale et le conScil genetique. L’experience du service de genetique humaine de Liege. J Genet Hum. 1985;33:275–81.
Craft H, Brazy JE. Autopsy: High yield in neonatal population. Am J Dis Child. 1986;140:1260–1262.
Meier RP, Manchester DK, Shikes RH, et al. Perinatal autopsy: Its clinical value. Obstet Gynecol. 1986;67:349–351.
Byrne J, Warburton D. Neural tube defects in spontaneous abortion. Am J Med Genet. 1986;25:327–333.
Simpson JL, Bombard AT. Chromosomal abnormalities in spontaneous abortions: Frequency, pathology and genetic counselling. In: Edmonds K, Bennet MJ, eds. Spontaneous abortion. London: Blackwell; 1987:51–76.
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Simpson, J.L. (1993). Genetic Causes of Spontaneous Abortion. In: Lin, CC., Verp, M.S., Sabbagha, R.E. (eds) The High-Risk Fetus. Springer, New York, NY. https://doi.org/10.1007/978-1-4613-9240-8_5
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DOI: https://doi.org/10.1007/978-1-4613-9240-8_5
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