| Objective:To explore the associativity among the angiogenesis status of chorionic villus, the ultrastructure of trophoblast cells and endothelial cells, the development and progression of early spontaneous abortion (ESA) through determining the vascular stereological density parameters and observing the ultrastructure of trophoblast cells and endothelial cells in patients with ESA.Methods:Fourty five patients with ESA were collected as research group and divided into three groups:abortion group A,15 patients with embryonic survival and symptoms of threatened abortion confirmed by B-ultrasonic; abortion group B,15 patients with embryonic stop development; and abortion group C,15 cases with empty pregnancy sac. Fifteen normal early pregnant women with embryonic survival urged the abortion in the same period were also including as control group (normal pregnancy group). For each group, Length density (Lv), Surface density (Sv) and Volume density (Vv) of villus vessels were detected by Stereology; Ultrastructure of trophoblast cells as well as endothelial cells in villus was also observed by transmission electron microscopy.Results:1. Stereological analysis of villus vessels:Lv in Abortion group A (3.89±0.80) was significantly lower than that in normal pregnancy group (5.18±1.02, P< 0.05); Sv and Vv in abortion group A (4.19±1.24 and 4.21±2.36, respectively) were not significantly different to those in normal pregnancy group (4.14±1.72 and 4.10±2.19, respectively; P>0.05); Lv, Sv and Vv in abortion group B (2.10±0.35, 2.35±1.18 and 2.48±2.09, respectively) were significantly lower than those in normal pregnancy group as well as abortion group A (P<0.05); Lv, Sv and Vv in abortion group C (0.96±0.37,0.88±0.72 and 0.73±0.96, respectively) were significantly lower than those in normal pregnancy group, abortion group A and abortion group B (P<0.05).2. Ultrastructure of villus:compared with normal pregnancy group, the alternations of ultrastructure in abortion group were as follows: swelling, fracture, loss or disappearance of microvillus on the surface of syncytiotrophoblast; cytoplasm degenerated, focal dissolution and necrosis of syncytiotrophoblast; swelling of mitochondria; dilating of endoplasmic reticulum; shrinkage of cell body; partial disintegration of contents; condensation and margination of chromatin; condensation, fragmentation and dissolution of nucleus. The ultrastructural changes in trophoblast cells and vascular endothelial cells were mild relatively. Desmosome connections between trophoblast cells and tight junctions between vascular endothelial cell were decrease or disappear.Conclusion:1. There was abnormal angiogenesis of chorionic villus in patients with ESA.2. There were some pathological ultrastructural changes of tropho-blast cells and endothelial cells in different degrees in patients with ESA; 3. The abnormal angiogenesis of chorionic villus was possible related to ultrastructural changes of trophoblast cells and endothelial cells, which might participate in the development and progression of early spontaneous abortion.
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