Detection of herpes simplex virus in first trimester pregnancy loss using molecular techniques.

BACKGROUND The etiology of early pregnancy loss is multifactorial and may include viral pathogens. The aim of this study was to investigate the presence of herpes simplex virus (HSV) in gestational tissues of first trimester pregnancy loss using molecular techniques. PATIENTS AND METHODS Gestational tissue from 95 women with first trimester pregnancy loss and 36 women with elective termination of pregnancy was investigated by nested polymerase chain reaction (PCR) and in situ hybridization techniques. RESULTS HSV was detected by the nested PCR technique in 41 out of the 95 (43.2%) cases of early pregnancy loss and in 6 out of the 36 (16.7%) cases of elective pregnancy termination (p=0.03). The HSV-positive cases in the early pregnancy loss group were observed between the 6th and the 12th gestational week and mostly in the 9th, 8th and 6th week. The in situ hybridization technique was successful in 18 out of 25 PCR-positive cases (72%) and revealed that the hybridization signal was mostly localized in the nuclei of the decidual and intermediate trophoblastic cells and less commonly in the chorionic villous trophoblastic cells. CONCLUSION HSV seems to play a significant role in first trimester pregnancy loss and its detection by sensitive and accurate molecular techniques would permit prompt antiviral therapy for a successful future pregnancy.