O-008 Improving outcomes in women with Mullerian anomalies

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
J Malhotra ◽  
N Malhotra ◽  
N Malhotra
Keyword(s):  
Pregnancy Loss ◽  
Intrauterine Growth Retardation ◽  
Recurrent Pregnancy Loss ◽  
Recurrent Miscarriage ◽  
Obstetric Outcome ◽  
Mullerian Anomalies ◽  
Intrauterine Growth ◽  
Müllerian Anomalies ◽  
Different Types ◽  
Registration Number

Abstract text Mullerian Anomalies are present in approximately 5% to 7% of the general population and the incidence is a little more in infertile and recurrent miscarriage women. Most of the recent studies have reported that the obstetric outcome is compromised in this group with greater risk of infertility, recurrent pregnancy loss, intrauterine growth retardation, preterm birth and many other obstetric complications, which may be individually related to the different types of Mullerian Anomalies. In this presentation, We are going to discuss on how the outcomes are different in the various Mullerian Anomalies depending upon the degree of the defects related to different complications with more profound defects. We will also discuss on how to optimize the pregnancy outcomes with various interventions and what the literature review supports. Trial registration number Study funding Funding source

scholarly journals Hypercoagulable Thrombophilic Defect and Hyperhomocysteinemia with Recurrent Pregnancy Loss

2016 ◽  
Vol 2 (3) ◽  
pp. 50-52
Author(s):  
PG Rooplata ◽  
Nagendra Prasad
Keyword(s):  
Pregnancy Loss ◽  
Intrauterine Growth Retardation ◽  
Recurrent Pregnancy Loss ◽  
Placental Abruption ◽  
Fetal Outcome ◽  
Intrauterine Fetal Death ◽  
Placental Perfusion ◽  
Intrauterine Growth ◽  
Changes In Pregnancy ◽  
Physiological Changes In Pregnancy

ABSTRACT Successful fetal outcome in any pregnancy is dependent on adequate placental circulation. Normal physiological changes in pregnancy produce a hypercoagulable state. Placental vasculature abnormalities may result in a number of gestational defects. They also can cause loss of pregnancy, intrauterine fetal death, intrauterine growth retardation, placental abruption, and preeclampsia. Hereditary thrombophilias are usually undiagnosed because most carriers are asymptomatic. Placental perfusion may be compromised by increased thrombosis that leads to pregnancy complications and recurrent pregnancy loss (RPL). We report a case of hypercoagulable thrombophilic defect and hyperhomocysteinemia with RPL. How to cite this article Rooplata PG, Nagarathnamma R, Prasad N. Hypercoagulable Thrombophilic Defect and Hyperhomocysteinemia with Recurrent Pregnancy Loss. J Med Sci 2016;2(3):50-52.

scholarly journals Hyperhomocysteinemia in Recurrent pregnancy loss

2017 ◽  
Vol 6 (7) ◽  
pp. 2919 ◽  
Author(s):  
Nisha Bhatia ◽  
Hemanshu B.
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Growth Retardation ◽  
Pregnancy Complications ◽  
Pregnancy Loss ◽  
Intrauterine Growth Retardation ◽  
Low Birthweight ◽  
Recurrent Pregnancy Loss ◽  
Hypertensive Disorder ◽  
Intrauterine Growth

Background: Hyperhomocysteinemia is associated with many pregnancy related complications. Its association with recurrent pregnancy loss has been investigated recently. Not only it is associated with recurrent pregnancy loss but also associated with complications like Preeclampsia, intrauterine growth retardation and low birth weight. The objective of this study to assess the prevalence of Hyperhomocysteinemia in patients with unexplained recurrent pregnancy loss and to evaluate the association of hyperhomocysteinemia with pregnancy complications in patients of recurrent pregnancy loss.Methods: 50 Patients of unexplained recurrent pregnancy loss were selected as cases and 50 patients with atleast one successful pregnancy were taken as controls. Their blood sample was assayed for Fasting Homocysteine levels. They were followed up throughout pregnancy for any complications and neonatal outcome was recorded.Results: 19 patients out of the 50 cases had Hyperhomocysteinemia. Hyperhomocysteinemia was thrice more common in Primary aborters when compared to secondary aborters. Out of 19 patients with hyperhomocysteinemia in patients with recurrent pregnancy loss, 14 patients also developed Hypertensive disorder of pregnancy during their antenatal period. Among patients with Hyperhomocysteinemia in study group, 47% had low birthweight babies when compared to 25% among control group.Conclusions: Hyperhomocysteinemia is associated with recurrent pregnancy loss and patients of Recurrent pregnancy loss who have Hyperhomocysteinemia have a higher risk of developing pregnancy complications like Preeclampsia, low birth weight and Intrauterine growth retardation.

Categories of intrauterine growth retardation

1993 ◽  
Vol 5 (4) ◽  
pp. 203-212 ◽  
Author(s):  
Roger A Fay ◽  
David A Ellwood
Keyword(s):  
Soft Tissue ◽  
Fetal Growth ◽  
Gestational Age ◽  
Growth Retardation ◽  
Large Scale ◽  
Intrauterine Growth Retardation ◽  
Low Birthweight ◽  
Ponderal Index ◽  
Intrauterine Growth ◽  
Different Types

Originally all low birthweight infants were considered to be premature. When prematurity was redefined in terms of gestational age (SGA) and not preterm. With the large scale collection of obstetric data the distributions of birthweight at different gestational ages were described and from these, infants who were SGA could be defined. SGA became synonymous with terms such as growth retardation, but it soon became appearent that the two were not necessarily interchangeable. Scott and Usher found that it was the degree of soft tissue wasting rather than birthweight that related to poor perinatal outcome. Miller and Hassanein stated that: “birthweight by itself is not a valid measure of fetal growth impairment”. They used Rorher’s Ponderal Index (weight (g) × 100/length (cm)) to diagnose the malnourished or excessively wasted infants with reduced soft tissue mass. Most studies of intrauterine growth retardation (IUGR) still use low birthweight for gestational age centile as their only definition of IUGR or only study infants who have a low birthweight. Altman and Hytten expressed disquiet about this definition and stated: “There is now an urgent need to establish true measures of fetal growth from which deviations indicating genuine growth retardation can be derived” and that “it is particularly important that some reliable measures of outcome should be established”. In large series of term deliveries published recently, two groups of IUGR infants with different growth patterens have been identified. These studies confirm that birthweight alone is inadequate to define the different types of IUGR. They established that low Ponderal Index (PI) is a measure of IUGR associated with an increased incidence of perinatal problems and that it is time to re-evaluate IUGR in terms of the different types of aberrant fetal growth.

Recurrent pregnancy loss and obstetric outcome

2006 ◽  
Vol 96 (1) ◽  
pp. 28-29 ◽  
Author(s):  
A.O. Hammoud ◽  
Z.O. Merhi ◽  
M. Diamond ◽  
P. Baumann
Keyword(s):  
Pregnancy Loss ◽  
Recurrent Pregnancy Loss ◽  
Obstetric Outcome

scholarly journals Hyperhomocysteinemia in recurrent pregnancy loss and the effect of folic acid and vitamin B12 on homocysteine levels: a prospective analysis

2017 ◽  
Vol 6 (6) ◽  
pp. 2258 ◽  
Author(s):  
Indrani Mukhopadhyay ◽  
V. Pruthviraj ◽  
Rao P. S. ◽  
Manash Biswas
Keyword(s):  
Folic Acid ◽  
Vitamin B12 ◽  
Pregnancy Loss ◽  
Recurrent Pregnancy Loss ◽  
Recurrent Miscarriage ◽  
The Body ◽  
Vitamin Supplementation ◽  
Vitamin B ◽  
History Of ◽  
A Prospective Study

Background: Recurrent pregnancy loss (RPL) affects about 5% of women. High levels of homocysteine, termed hyperhomocysteinemia, have been implicated in a number of pathologic processes in the venous and arterial vascular systems. Hyperhomocysteinemia in pregnant women has been associated with deep venous thrombosis, recurrent miscarriage, abruption placentae, preeclampsia, neural tube defects, and fetal growth restriction. This study aims at determining association between hyperhomocysteinemia and recurrent pregnancy loss and also association of folic acid (vitamin B 9) and vitamin B 12 with hyperhomocysteinemia (HHCY), in reducing its levels in the body and thus preventing obstetric complications.Methods: A prospective study of pregnant mothers booked at our hospital over a period of two years with history of unexplained RPL were included in the study and their serum homocysteine levels were assessed. Hyperhomocysteinemia (>12 micromol/l) patients were treated with folic acid and vitamin B12 supplements and homocysteine levels were assessed again, post treatment.Results: Out of the 100 patients who were assessed, 32% of RPL patients had hyperhomocysteinemia. Folic acid and VitB12 supplementation reduced homocysteine levels and this was found to be statistically significant.Conclusions: Hyperhomocysteinemia is associated with RPL. Vitamin supplementation to those with hyperhomocysteinemia, decreases homocysteine levels.

scholarly journals Neonatal Outcomes after Preconceptional Vaginal Micronized Progesterone Administration in Recurrent Pregnancy Loss: Five Years Prospective Study

2014 ◽  
Vol 8 (2) ◽  
pp. 128-133
Author(s):  
Manuela Russu ◽  
Ruxandra Stănculescu ◽  
Maria Păun ◽  
Jan Andi Marin
Keyword(s):  
Prospective Study ◽  
Gestational Age ◽  
Pregnancy Loss ◽  
Recurrent Pregnancy Loss ◽  
Recurrent Miscarriage ◽  
Preterm Births ◽  
Neonatal Morbidity ◽  
Neonatal Outcomes ◽  
Control Group ◽  
Micronized Progesterone

ABSTRACT Objectives The objective of this prospective study was to analyze the effect of vaginal micronized progesterone (VMP) daily administrated in women with recurrent pregnancy loss, recurrent miscarriage, and/or preterm birth on neonatal outcomes. Methods In the treat group patients received 200 mg/day VMP (14 days/month, during the luteal phase) from preconception until completed 36 weeks of gestation. Women from the control group did not receive VPM treatment. Ultrasonographic examination was performed for gestational age confirmation, assessment of cervical length and congenital malformation screening in fetus. Results Compared with the control group, the women from the VMP group had a decreased time to conception, lower frequency of miscarriages and higher gestational age at delivery. Newborns from mothers treated with VPM had significantly higher birth weight than newborns from the control group of mothers (p = 0.022). The frequency of stillbirths and the need for oxygen supplementation and mechanical ventilation was lower in the newborns from treated group of mother compared with control group. Conclusion Vaginal micronized progesterone 200 mg/day from preconception to 36 weeks of gestation in women with recurrent pregnancy loss reduced the frequency of miscarriages, stillbirths, preterm births and neonatal morbidity. How to cite this article Russu M, Stănculescu R, Păun M, Marin JA. Neonatal Outcomes after Preconceptional Vaginal Micronized Progesterone Administration in Recurrent Pregnancy Loss: Five Years Prospective Study. Donald School J Ultrasound Obstet Gynecol 2014;8(2):128-133.

scholarly journals http://www.jirb.dormaj.com/issues/Volume%205,%20Issue%204/Anti-Coagulant%20Therapy%20in%20Unexplained%20Recurrent%20Pregnancy%20Loss.pdf

2017 ◽  
Vol 5 (4) ◽  
pp. 15-19
Keyword(s):  
Molecular Weight ◽  
Live Birth ◽  
Low Molecular Weight Heparin ◽  
Pregnancy Loss ◽  
Recurrent Pregnancy Loss ◽  
Recurrent Miscarriage ◽  
Controlled Study ◽  
Low Molecular Weight ◽  
Antiphospholipid Antibody ◽  
History Of

Recurrent pregnancy loss (RPL) is a heterogeneous reproductive problem with multiple aetiologies and contributing factors. It becomes quite challenging to form a work-up to detect the cause of RPL in the early months as a continuation of pregnancy involves many factors. In more than half of all recurrent miscarriage the cause still remains uncertain. Thrombophilia has been identified in about 50% of women with recurrent miscarriage and thromboprophylaxis has been suggested as an option of treatment.. In obstetric APLA Syndrome (Antiphospholipid antibody) the combination of aspirin and heparin has improved outcomes. The use of low molecular weight heparin (LMWH) has become a common practise in women with inherited thrombophilia and also those with unexplained miscarriage to help safeguard the ongoing pregnancy. To evaluate if there is any effectiveness of low molecular weight heparin (enoxaparin) in women with a history of at least two miscarriages without any apparent aetiology for recurrent pregnancy loss. A prospective randomised controlled study held at Vivekananda Institute of Medical Sciences, Kolkata from August 2015- July 2018. The study assessed the effect of anticoagulant treatment on the live-birth rate (primary outcome) in 80 antenatal women with a history of at least two miscarriages without any apparent causes. Interventions included low molecular weight heparin administration in one group and the other one was not given any anti-coagulant therapy. Similar live birth rates were observed with enoxaparin and the patients who did not receive any anti-coagulant, respectively 84% and 82% (RR 0.97, 95% CI 0.81 to 1.16). There were no significant differences in live birth weight and other pregnancy outcomes between the two groups. Therefore, there is no evidence to support any incremental benefit of adding LMWH to the treatment as a routine in unexplained cases of recurrent pregnancy loss.

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