Reproductive Outcome After Hysteroscopic Correction of Subtle Uterine Septum or Arcuate Uterine Anomaly in Patients with Recurrent Pregnancy Loss (RPL)

2016 ◽  
Vol 23 (7) ◽  
pp. S186
Author(s):  
O Abuzeid ◽  
A Mostafa ◽  
A Abdullah ◽  
J Hebert ◽  
F Rocha ◽  
...  
Keyword(s):  
Pregnancy Loss ◽  
Recurrent Pregnancy Loss ◽  
Reproductive Outcome ◽  
Uterine Anomaly ◽  
Uterine Septum

P-377 Association between antinuclear antibodies and pregnancy prognosis in recurrent pregnancy loss patients

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
H Yoshihara ◽  
M Sugiura-Ogasawara ◽  
T Kitaori ◽  
S Goto
Keyword(s):  
Live Birth ◽  
Pregnancy Loss ◽  
Birth Rate ◽  
Recurrent Pregnancy Loss ◽  
Live Birth Rate ◽  
Negative Group ◽  
Birth Rates ◽  
Positive Group ◽  
Live Birth Rates ◽  
Uterine Anomaly

Abstract Study question Can antinuclear antibody (ANA) affect the subsequent live birth rate in patients with recurrent pregnancy loss (RPL) who have no antiphospholipid antibodies (aPLs)? Summary answer ANA did not affect the pregnancy prognosis of RPL women. What is known already The prevalence of ANA is well-known to be higher in RPL patients. Our previous study found no difference in the live birth rates of ANA-positive and -negative patients who had no aPLs. Higher miscarriage rates were also reported in ANA-positive patients compared to ANA-negative patients with RPL. The RPL guidelines of the ESHRE state that “ANA testing can be considered for explanatory purposes.” However, there have been a limited number of studies on this issue and sample sizes have been small, and the impact of ANA on the pregnancy prognosis is unclear. Study design, size, duration An observational cohort study was conducted at Nagoya City University Hospital between 2006 and 2019. The study included 1,108 patients with a history of 2 or more pregnancy losses. Participants/materials, setting, methods 4D-Ultrasound, hysterosalpingography, chromosome analysis for both partners, aPLs and blood tests for ANA and diabetes mellitus were performed before a subsequent pregnancy. ANAs were measured by indirect immunofluorescence. The cutoff dilution used was 1:40. In addition, patients were classified according to the ANA pattern on immunofluorescence staining. Live birth rates were compared between ANA-positive and ANA-negative patients after excluding patients with antiphospholipid syndrome, an abnormal chromosome in either partner and a uterine anomaly. Main results and the role of chance The 994 patients were analyzed after excluding 40 with a uterine anomaly, 43 with a chromosome abnormality in either partner and 32 with APS. The rate of ANA-positive patients was 39.2 % (390/994) when the 1: 40 dilution result was positive. With a 1:160 dilution, the rate of ANA-positive patients was 3.62 % (36/994). The live birth rate was calculated for 798 patients, excluding 196 patients with unexplained RPL who had been treated with any medication. With the use of the 1 40 dilution, the subsequent live birth rates were 71.34 % (219/307) for the ANA-positive group and 70.67 % (347/491) for the ANA-negative group (OR, 95%CI; 0.968, 0.707-1.326). After excluding miscarriages with embryonic aneuploidy, chemical pregnancies and ectopic pregnancies, live birth rates were 92.41 % (219/237) for the ANA-positive group and 92.04 % (347/377) for the ANA-negative group (0.951, 0.517-1.747). Using the 1:160 dilution, the subsequent live birth rates were 84.62 % (22/26) for the ANA-positive group, and 70.47 % (544/772) for the ANA-negative group (0.434, 0.148-1.273). Subgroup analyses were performed for each pattern on immunofluorescence staining, but there was no significant difference in the live birth rate between the two groups. Limitations, reasons for caution The effectiveness of immunotherapies could not be evaluated. However, the results of this study suggest that it is not necessary. Wider implications of the findings The measurement of ANA might not be necessary for the screening of patients with RPL who have no features of collagen disease. Trial registration number not applicable

scholarly journals The role of diagnostic hysteroscopy in diagnosis of incomplete uterine septum in patients with recurrent pregnancy loss in the era of transvaginal 3D ultrasound scan

2019 ◽  
Vol 16 (1) ◽  
Author(s):  
O. Abuzeid ◽  
J. LaChance ◽  
J. Hebert ◽  
M. I. Abuzeid ◽  
R. Welch
Keyword(s):  
Pregnancy Loss ◽  
Recurrent Pregnancy Loss ◽  
3D Ultrasound ◽  
Acute Angle ◽  
Central Point ◽  
Obtuse Angle ◽  
Ultrasound Scan ◽  
Uterine Septum ◽  
Diagnostic Hysteroscopy ◽  
The Mean

Abstract Purpose To determine the accuracy of transvaginal 3D ultrasound scan (TV 3D US) in detecting partial septate uterus (PSU) in patients with recurrent pregnancy loss (RPL). Methods This retrospective study included 113 patients with an initial diagnosis of unexplained RPL, who were subsequently found to have PSU on diagnostic hysteroscopy and who had TV 3D US prior to surgery. The diagnosis of PSU was made at the time of a diagnostic hysteroscopy based on ESHRE-ESGE classification of Müllerian anomalies. Based on hysteroscopic findings, patients were divided into two groups: those with PSU and a central point of indentation at an acute angle < 90° (PSUAA) [30.1%], and those who had PSU and a central point of indentation at an obtuse angle (PSUOA) [69.9%]. We compared the mean internal indentation length at the fundal midline (IILFM) in millimeters on TV 3D US and on diagnostic hysteroscopy. For the purpose of this study, a diagnosis of PSU on hysteroscopy was made if IILFM measured ≥ 10 mm. Results The mean IILFM (mm) on hysteroscopy was significantly higher than the mean IILFM (mm) measured on TV 3D US in patients with PSUAA (18.5 ± 6.5 vs 4.9 ± 4.4; P < 0.001), in patients with PSUOA (14.1 ± 3.8 vs 4.3 ± 3.4; P < 0.001), and in the overall population (15.3 ± 5.1 vs 4.1 ± 4.4; P < 0.001). Conclusions The data suggest that mean IILFM in patients with RPL and PSU can be underestimated on TV 3D US. Therefore, its diagnostic accuracy in such patients may need further evaluation.

Hysteroscopy in the Evaluation of Recurrent First Trimesteric Miscarriages

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
A I Abdelmageed ◽  
M M Alsherbiny ◽  
A M Abdelhamed ◽  
W Y Alsaleem
Keyword(s):  
Pregnancy Loss ◽  
Recurrent Pregnancy Loss ◽  
Treatment Strategies ◽  
Uterine Cavity ◽  
First Trimester ◽  
Maternity Hospital ◽  
Uterine Septum ◽  
Study Population ◽  
Diagnostic Hysteroscopy

Abstract Background Recurrent pregnancy loss (RPL) is one of the most frustrating and difficult areas in reproductive medicine because the etiology is often unknown and there are few evidence-based diagnostic and treatment strategies. Studies on the etiology, evaluation, and management of RPL are often flawed, uterine factors (acquired and congenital)are responsible for 10 to 50 %of recurrent pregnancy loss,hysteroscopy is the gold standard for evaluation of the eendometrial cavity. Aim of the work to evaluate the role of hysteroscopy in the diagnosis of possible uteri.ne congenital and acquired causes of recurrent first trimesteric miscarriages. Patients and methods This prospective cohort study was conducted on 164 patients with recurrent (3 or more), first trimester miscarriage planned to undergo office (diagnostic) hysteroscopy to assess the uterine cavity, who attend Ain Shams University maternity Hospital Early Cancer detection Unit during period from July 2018 to December 2018. Results the largest proportion 53% of our study population had abnormal hysteroscopic findings, and the uterine septum had the highest prevalence among women with recurrent first trimesteric miscarriages. Conclusion In women with recurrent pregnancy loss, hysteroscopy is a useful diagnostic tool in the diagnosis of possible uterine causes of recurrent miscarriages. Uterine septum is the most common congenital uterine abnormality found in patients with recurrent first trimesteric miscarriages.

Uterine Anomaly and Recurrent Pregnancy Loss

2011 ◽  
Vol 29 (06) ◽  
pp. 514-521 ◽  
Author(s):  
Mayumi Sugiura-Ogasawara ◽  
Yasuhiko Ozaki ◽  
Kinue Katano ◽  
Nobuhiro Suzumori ◽  
Eita Mizutani
Keyword(s):  
Pregnancy Loss ◽  
Recurrent Pregnancy Loss ◽  
Uterine Anomaly

scholarly journals Reproductive outcome in pregnant women with recurrent pregnancy loss

2015 ◽  
Vol 37 (12) ◽  
pp. 578-584
Author(s):  
Olivia Lúcia Nunes Costa ◽  
Eliane Menezes Flores Santos ◽  
Viviane Silva de Jesus ◽  
Eduardo Martins Netto
Keyword(s):  
Pregnant Women ◽  
Pregnancy Loss ◽  
Recurrent Pregnancy Loss ◽  
Reproductive Outcome

P–377 Association between antinuclear antibodies and pregnancy prognosis in recurrent pregnancy loss patients

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
H Yoshihara ◽  
M Sugiura-Ogasawara ◽  
T Kitaori ◽  
S Goto
Keyword(s):  
Live Birth ◽  
Pregnancy Loss ◽  
Birth Rate ◽  
Recurrent Pregnancy Loss ◽  
Live Birth Rate ◽  
Negative Group ◽  
Birth Rates ◽  
Positive Group ◽  
Live Birth Rates ◽  
Uterine Anomaly

Abstract Study question Can antinuclear antibody (ANA) affect the subsequent live birth rate in patients with recurrent pregnancy loss (RPL) who have no antiphospholipid antibodies (aPLs)? Summary answer ANA did not affect the pregnancy prognosis of RPL women. What is known already The prevalence of ANA is well-known to be higher in RPL patients. Our previous study found no difference in the live birth rates of ANA-positive and -negative patients who had no aPLs. Higher miscarriage rates were also reported in ANA-positive patients compared to ANA-negative patients with RPL. The RPL guidelines of the ESHRE state that “ANA testing can be considered for explanatory purposes.” However, there have been a limited number of studies on this issue and sample sizes have been small, and the impact of ANA on the pregnancy prognosis is unclear. Study design, size, duration An observational cohort study was conducted at Nagoya City University Hospital between 2006 and 2019. The study included 1,108 patients with a history of 2 or more pregnancy losses. Participants/materials, setting, methods 4D-Ultrasound, hysterosalpingography, chromosome analysis for both partners, aPLs and blood tests for ANA and diabetes mellitus were performed before a subsequent pregnancy. ANAs were measured by indirect immunofluorescence. The cutoff dilution used was 1:40. In addition, patients were classified according to the ANA pattern on immunofluorescence staining. Live birth rates were compared between ANA-positive and ANA-negative patients after excluding patients with antiphospholipid syndrome, an abnormal chromosome in either partner and a uterine anomaly. Main results and the role of chance The 994 patients were analyzed after excluding 40 with a uterine anomaly, 43 with a chromosome abnormality in either partner and 32 with APS. The rate of ANA-positive patients was 39.2% (390/994) when the 1: 40 dilution result was positive. With a 1:160 dilution, the rate of ANA-positive patients was 3.62% (36/994). The live birth rate was calculated for 798 patients, excluding 196 patients with unexplained RPL who had been treated with any medication. With the use of the 1: 40 dilution, the subsequent live birth rates were 71.34% (219/307) for the ANA-positive group and 70.67% (347/491) for the ANA-negative group (OR, 95%CI; 0.968, 0.707–1.326). After excluding miscarriages with embryonic aneuploidy, chemical pregnancies and ectopic pregnancies, live birth rates were 92.41% (219/237) for the ANA-positive group and 92.04% (347/377) for the ANA-negative group (0.951, 0.517–1.747). Using the 1:160 dilution, the subsequent live birth rates were 84.62% (22/26) for the ANA-positive group, and 70.47% (544/772) for the ANA-negative group (0.434, 0.148–1.273). Subgroup analyses were performed for each pattern on immunofluorescence staining, but there was no significant difference in the live birth rate between the two groups. Limitations, reasons for caution The effectiveness of immunotherapies could not be evaluated. However, the results of this study suggest that it is not necessary. Wider implications of the findings: The measurement of ANA might not be necessary for the screening of patients with RPL who have no features of collagen disease. Trial registration number Not applicable

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