AJR//994; 32:211-220 Printed in the United States of America - all rights reserved. Copyright © Munksgaard, /994 American Journal of Reproductive Immunology /SSN 8755-8920 The Presence of Cytomegalovirus Antigens in Karyotyped Abortions GESINA VANLlJNSCHOTEN, FRANS STALS, JOHANNES L.H. EVERS, CATHARINA A. BRUGGEMAN, MICHAEL H. HAVENITH, AND JOSEPH P.M. GERAEDTS The Presence of Cytomegalovirus Antigens in Karyotyped Abortions. van Lijnschoten G, Stals F, Evers JLH, Bruggeman CA, Havenith MH, Geraedts JPM, AiRI. 1994; 32 :2II-220 © Munskgaard, Copenhagen PROBLEM: About one out of six pregnancies ends in spontaneous abortion before the 17th week. In more than half of these a chromosome abnormality is present, which explains the abortion. The role of cytomegalovirus (CMV) infections in early pregnancy failure is un- clear. If there is a role for CMV, a preponderance of infections would be expected in a chro- mosomally normal group. METHOD: The significance of CMV in abortions has been studied by screening 80 spon- taneous and nine induced abortions with known karyotype for the presence of phospho- protein pp65, an early CMV antigen. Also, endometrial biopsies (n = 55) and menstruum (n = 10) were screened. In 11 patients more than one specimen was available for study. RESULT: The protein was present in the glandular epithelium of the decidua of spontane- ous as well as induced abortions in 31 of 89 (35%) cases, irrespective of chromosomal con- stitution. Trophoblastic cells were pp65 positive in 6/89 cases. A total of 17 embryos could be studied, seven of which were positive. Positive staining of embryonic organs correlated strongly with the presence of the antigen in the decidua. The endometrial biopsies and men- strual discharges from women of comparable ages showed the same percentages of posi- tive tests for pp65: 35 and 20%. Histologically positive and negative specimens could not be differentiated other than by the specific staining. In 10 of 11 patients with more than one specimen available, the results were consistent. One patient had two positive and one negative specimen. CONCLUSION: The findings indicate that in early pregnancy cytomegalovirus is trans- mitted from the decidual glands to the foetus. However, we have not found indications that the presence of cytomegalovirus infection as shown by the presence of antigen is patho- genic for early pregnancy. INTRODUCTION About one of six clinically recognized pregnancies ends in spontaneous abor- tion before the 17th week of gestational age."? More than half of the abor- tions can be explained by chromosomal abnormalities.T" The role of CMV Key words: spontaneous abortion, cytomegalovirus, pp65, endometrial biopsy. GESINA VAN LIJNSCHOTEN JOSEPH P.M. GERAEDTS Department of Molecular Cell Biology & Genetics, University Limburg, The Netherlands FRANS STALS CATHARINA A. BRUGGEMAN Department of Virology, Academic Hospital Maastricht, The Netherlands JOHANNES L.H. EVERS Department of Obstetrics & Gynaecology, Academic Hospital Maastricht, The Netherlands MICHAEL H. HAVENITH Regional Pathology Laboratory, Enschede, The Netherlands Presented at the 41st Annual Meeting of the Society for Gynecologic Investigation, March 22 to March 26, 1994, Chicago, Illinois. Submitted April 24, 1994; accepted June 16, 1994. Address reprint requests to G. van Lijnschoten, presently Dept. of Histopathology, Addenbrooke's Hospital, Cambridge CB2 2QQ, England. AMERICAN JOURNAL OF REPRODUCTIVE IMMUNOLOGY VOL. 32, 1994