Midwifery Management of First Trimester Bleeding and Early Pregnancy Loss

2000 ◽  
Vol 45 (6) ◽  
pp. 481-497 ◽  
Author(s):  
Katrina Alef Thorstensen
Keyword(s):  
Early Pregnancy ◽  
Pregnancy Loss ◽  
First Trimester ◽  
Early Pregnancy Loss

scholarly journals Role of human chorionic gonadotrophin to prevent repeated early pregnancy loss

2016 ◽  
Vol 48 (1-2) ◽  
pp. 7-10
Author(s):  
Eti Saha ◽  
Fouzia Begum ◽  
Zannatul Ferdous Jesmin
Keyword(s):  
Early Pregnancy ◽  
Pregnancy Loss ◽  
First Trimester ◽  
Additional Treatment ◽  
Chorionic Gonadotrophin ◽  
Human Chorionic Gonadotrophin ◽  
Early Pregnancy Loss ◽  
Significant Difference ◽  
Improve Pregnancy Outcome ◽  
History Of

Early pregnancy loss is a frustrating experience for both the patient and the physician. Approximately 5% of couples trying to conceive have 2 consecutive miscarriages and approximately 1% couples have 3 or more consecutive losses. Objective of this study is to determine whether therapy with dydrogesterone or Human chorionic Gonadotrophin hormone (HCG) in history of repeated pregnancy loss during the first trimester of pregnancy will improve pregnancy outcome. This is a prospective open comparative study.Women having early pregnancy presenting to a private clinic with history of early pregnancy loss, having no medical disorder were included in this study. Eligible subjects were randomised to receive either dydrogesterone 20mg daily or injection Human Chorionic Gonadotrophins (HCG) 5000 iu intramuscularly at 72 hours interval up to fourteen weeks of pregnancy or no additional treatment. Follow up of those patients were done with transabdominal ultrasonography. Hundred women were recruited. There was no statistically significant difference between the three groups with regard to pretreatment status. The continuing pregnancy success rate was higher in women treated with dydrogesterone (79.17%) and highest with Injection Human Chorionic, Gonadotrophin (86.36%) compared with women received no treatment (70%), (p=0.358). Hormonal support with either dydrogesterone or Human Chorionic Gonadotrophin may increase the chances of a successful pregnancy in women with a history of spontaneous abortion.Bang Med J (Khulna) 2015; 48 : 7-10

First-trimester maternal dried blood Down syndrome screening marker levels in early pregnancy loss

2006 ◽  
Vol 26 (12) ◽  
pp. 1137-1141 ◽  
Author(s):  
David Krantz ◽  
Terrence Hallahan ◽  
Stephanie Ishack ◽  
V. James Macri ◽  
James N. Macri
Keyword(s):  
Down Syndrome ◽  
Early Pregnancy ◽  
Pregnancy Loss ◽  
First Trimester ◽  
Early Pregnancy Loss ◽  
Screening Marker ◽  
Down Syndrome Screening

scholarly journals Oxidative Stress Markers in Early Pregnancy Loss: A Case-Control Study

2018 ◽  
Vol 7 (1) ◽  
pp. 61-66 ◽  
Author(s):  
Shahnaz Torkzahrani ◽  
Padideh Janati Ataei ◽  
Mehdi Hedayati ◽  
Soheila Khodakarim ◽  
Zohre Sheikhan ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Uric Acid ◽  
Pregnant Women ◽  
Spontaneous Abortion ◽  
Early Pregnancy ◽  
Pregnancy Loss ◽  
First Trimester ◽  
Demographic Characteristics ◽  
Early Pregnancy Loss ◽  
First Trimester Of Pregnancy

Objectives: Evidence suggests that oxidative stress (OS) plays a prominent role in the pathophysiology of pregnancy complications in women. The present study was conducted to determine the levels of OS markers in early pregnancy loss and to compare the results with those in healthy pregnant women. Materials and Methods: A total of 32 women with early pregnancy loss and 32 healthy women in the first trimester of pregnancy, with similar demographic characteristics entered this study as the cases and controls. Serum levels of malondialdehyde (MDA), total antioxidant capacity (TAC), uric acid, and bilirubin levels were determined in both groups. The data obtained were then analyzed and compared between the groups using the independent samples t test and Mann-Whitney U test. Results: The 2 groups matched in terms of personal-demographic characteristics including mother’s age, father’s age, gravidity, and body mass index (BMI). MDA levels increased significantly in the women with spontaneous abortion compared to the healthy pregnant women (4.35±1.47 vs. 3.42±1.68 µM/L; P=0.026) and TAC decreased significantly in the cases compared to the healthy controls (552.34±212.79 vs. 1003.23±1168.68 U/mL; P=0.040). Uric acid and bilirubin levels did not differ between the groups. Conclusions: The results of this study provides further evidence on the effect of increased OS on the incidence of early spontaneous abortion in the first trimester of pregnancy. High serum MDA levels and low TAC during pregnancy were 2 risk factors for spontaneous abortion. The present findings support the hypothesis that OS plays a key role in the etiopathogenesis of spontaneous abortion. Further studies are required for assessing the preventive role of antioxidant therapy in this complication.

scholarly journals How does subchorionic hematoma in the first trimester affect pregnancy outcomes?

2021 ◽  
Author(s):  
Taner Günay ◽  
Oğuz Yardımcı
Keyword(s):  
Pregnant Women ◽  
Preterm Delivery ◽  
Early Pregnancy ◽  
Pregnancy Outcomes ◽  
Vaginal Bleeding ◽  
Pregnancy Loss ◽  
Placental Abruption ◽  
First Trimester ◽  
Early Pregnancy Loss ◽  
Adverse Pregnancy

IntroductionSubchorionic hematoma (SCH) in pregnancy has been associated with increased risk of adverse pregnancy outcomes. We aimed to investigate the association of SCH with adverse pregnancy outcomes in pregnant women in relation to size of hematoma and control subjects.Material and methodsThis study included 178 pregnant women with sonographically detected SCH in the 1st trimester, and 350 pregnant controls without SCH. Data on maternal age, smoking status, gestational week at diagnosis, location of SCH, medications before diagnosis, gestational week at delivery, delivery route and pregnancy outcomes (first trimester vaginal bleeding, pre-eclampsia, gestational diabetes, intrauterine growth restriction (IUGR), placental abruption, preterm delivery < 37 weeks, early pregnancy loss and intrauterine death) were retrieved retrospectively from hospital records. Pregnant women with SCH were divided into 3 groups according to the size of hematoma including small SCH (SCH-I group, n = 47), medium- size SCH (SCH-II group, n = 110) and large SCH (SCH-III group, n = 21) groups.ResultsSubchorionic hematoma was associated with significantly lower gestational age at delivery (p < 0.001) and higher rate of first trimester bleeding (p < 0.001) compared with the control group, regardless of the size of the hematoma. Placental abruption (p = 0.002) and early pregnancy loss (p < 0.001) were significantly more common in SCH-II and -III groups than in the control group. SCH-III group was associated with a significantly higher rate of < 37 gestational weeks at delivery (p < 0.001), first trimester vaginal bleeding (p < 0.001), early pregnancy loss (p < 0.001), IUGR (p = 0.003) and preterm delivery (p < 0.001) compared to both lesser size hematoma and control groups.ConclusionsIn conclusion, our findings suggest that large SCH might indicate an increased risk of adverse pregnancy outcomes such as 1st trimester vaginal bleeding, early pregnancy loss, IUGR, placental abruption or preterm delivery. These findings are important to guide the patients with SCH for detailed clinical evaluation.

504: First Trimester Bacterial Vaginosis and Early Pregnancy Loss

2005 ◽  
Vol 161 (Supplement_1) ◽  
pp. S126-S126
Author(s):  
D B Nelson ◽  
S Bellamy ◽  
I Nachamkin ◽  
L Allen-Taylor ◽  
H Wang
Keyword(s):  
Bacterial Vaginosis ◽  
Early Pregnancy ◽  
Pregnancy Loss ◽  
First Trimester ◽  
Early Pregnancy Loss

scholarly journals P120: A survey of Ontario Family Health Teams: Family physicians are reliant on emergency services for complicated early pregnancy loss

CJEM ◽  
2020 ◽  
Vol 22 (S1) ◽  
pp. S108-S108
Author(s):  
J. Cirone ◽  
C. Thompson ◽  
S. McLeod ◽  
C. Varner
Keyword(s):  
Ectopic Pregnancy ◽  
Family Physician ◽  
Early Pregnancy ◽  
Pregnancy Loss ◽  
Family Health ◽  
Family Physicians ◽  
First Trimester ◽  
Early Pregnancy Loss ◽  
Missed Abortion ◽  
Obstetrical Care

Introduction: The majority of first trimester pregnancy care in Canada is provided by family physicians and emergency departments (EDs). Early pregnancy loss occurs in approximately 30% of pregnancies, and the majority take place in first trimester when many patients do not yet have an obstetrical care provider. In Ontario, nearly 70% of patients are rostered to a family physician, many of whom practice in Family Health Teams (FHTs). The objective of this study was to determine how Ontario family physicians manage early pregnancy complications and explore the services available for patients experiencing early pregnancy loss or threatened early pregnancy loss. Methods: Family physician leads from 104 Ontario FHTs were contacted by email and invited to complete a 19-item, online questionnaire using modified Dillman methodology. The survey was developed by investigators based on a review of relevant literature and consultation with clinical experts. Prior to distribution, the questionnaire was peer reviewed and tested for face and construct validity, as well as ease of comprehension. Results: Respondents from 50 FHTs across Ontario completed the survey (response rate 48.1%). Of the respondents, 45 (90.0%) reported access to an ED in their community, 45 (90.0%) had access to an obstetrician/gynecologist, 33 (66.0%) had access to an early pregnancy clinic, and 18 (36.0%) reported comprehensive obstetrical care from first trimester to delivery within their FHT. The following services were only accessible through the ED: administration of RhoGAM (n = 28; 56.0%); surgical management of spontaneous or missed abortion (n = 22; 44.0%); same day serum quantitative beta human chorionic gonadotropin (n = 21; 42.0%); same day radiologist-interpreted ultrasound assessment (n = 15; 30.0%); and medical management of spontaneous or missed abortion (n = 12; 24.0%). Forty (80.0%) respondents stated physicians in their practice would provide urgent follow-up care for patients with spontaneous abortion, 35 (70.0%) would provide care for threatened abortion, and 26 (52.0%) would provide urgent care for missed abortion. For patients with a stable ectopic pregnancy, 37 (74.0%) respondents would refer to the ED. Conclusion: This study suggests FHTs in Ontario provide comprehensive care to patients with uncomplicated early pregnancy loss such as spontaneous abortion, yet rely on the ED for management of complicated early pregnancy loss, when medical or surgical management is indicated or for ectopic pregnancy.

scholarly journals TEAD4 ensures postimplantation development by promoting trophoblast self-renewal: An implication in early human pregnancy loss

2020 ◽  
Vol 117 (30) ◽  
pp. 17864-17875 ◽  
Author(s):  
Biswarup Saha ◽  
Avishek Ganguly ◽  
Pratik Home ◽  
Bhaswati Bhattacharya ◽  
Soma Ray ◽  
...  
Keyword(s):  
Signaling Pathway ◽  
Early Pregnancy ◽  
Pregnancy Loss ◽  
First Trimester ◽  
Hippo Signaling ◽  
Early Pregnancy Loss ◽  
Self Renewal ◽  
Hippo Signaling Pathway ◽  
Trophoblast Stem ◽  
Early Human

Early pregnancy loss affects ∼15% of all implantation-confirmed human conceptions. However, evolutionarily conserved molecular mechanisms that regulate self-renewal of trophoblast progenitors and their association with early pregnancy loss are poorly understood. Here, we provide evidence that transcription factor TEAD4 ensures survival of postimplantation mouse and human embryos by controlling self-renewal and stemness of trophoblast progenitors within the placenta primordium. In an early postimplantation mouse embryo, TEAD4 is selectively expressed in trophoblast stem cell–like progenitor cells (TSPCs), and loss ofTead4in postimplantation mouse TSPCs impairs their self-renewal, leading to embryonic lethality before embryonic day 9.0, a developmental stage equivalent to the first trimester of human gestation. Both TEAD4 and its cofactor, yes-associated protein 1 (YAP1), are specifically expressed in cytotrophoblast (CTB) progenitors of a first-trimester human placenta. We also show that a subset of unexplained recurrent pregnancy losses (idiopathic RPLs) is associated with impaired TEAD4 expression in CTB progenitors. Furthermore, by establishing idiopathic RPL patient-specific human trophoblast stem cells (RPL-TSCs), we show that loss of TEAD4 is associated with defective self-renewal in RPL-TSCs and rescue of TEAD4 expression restores their self-renewal ability. Unbiased genomics studies revealed that TEAD4 directly regulates expression of key cell cycle genes in both mouse and human TSCs and establishes a conserved transcriptional program. Our findings show that TEAD4, an effector of the Hippo signaling pathway, is essential for the establishment of pregnancy in a postimplantation mammalian embryo and indicate that impairment of the Hippo signaling pathway could be a molecular cause for early human pregnancy loss.

scholarly journals Hypothyroidism and early pregnancy loss: an overview

2020 ◽  
Vol 9 (12) ◽  
pp. 5065
Author(s):  
Puja Verma ◽  
Dipti Roy
Keyword(s):  
Early Pregnancy ◽  
Pregnancy Loss ◽  
First Trimester ◽  
Thyroid Disorders ◽  
Early Pregnancy Loss ◽  
Thyroid Status ◽  
The Mean ◽  
Adverse Pregnancy ◽  
Thyroid Profile ◽  
Status Of Women

Background: Thyroid disorders are associated with adverse pregnancy outcomes and can lead to spontaneous miscarriages.Methods: One hundred and four women with early pregnancy loss were enrolled in this study and thyroid profile was done. Thyroid status of women was established on the basis of standard cut-off levels. Prevalence of hypothyroidism (both overt and subclinical) was calculated.Results: The mean TSH level was 2.3±1.3 μIU/l. Twenty two women had increased TSH level (>2.5 μIU/l) accounting to 21.15% of total women and rest 78.84% women were euthyroid. 15.38% of women presenting with early pregnancy loss were overt hypothyroid and 5.76% of women had subclinical hypothyroidism. The mean TSH level in hypothyroid group was 4.9±2.1.Conclusions: Hypothyroidism if untreated can lead to first trimester abortions. All pregnant women should be screened for thyroid disorders in their first visit and treatment should be started at the earliest.

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