Practical Work-up and Management of Recurrent Pregnancy Loss for the Front-Line Clinician

2016 ◽  
Vol 59 (3) ◽  
pp. 535-538 ◽  
Author(s):  
D. WARE BRANCH ◽  
ROBERT M. SILVER
Author(s):  
Anu Bhargavi W. B. ◽  
Sailatha R. ◽  
Anuradha C. R.

Background: The death of an infant, in utero or after birth has been a devastating experience for parents and clinicians alike. Various efforts are being made to make an accurate diagnosis of such pregnancy losses at the earliest to prevent the emotional and physical stress that the woman undergoes. This study aims to assess the changing trends in risk factors and outcome of pregnancies in cases of bad obstetric history (BOH) and to identify the newly emerging maternal and fetal factors contributing to incidence of pregnancy loss.Methods: This study is a retrospective analysis of antenatal women with BOH attending the obstetrics and gynecology OPD at Chettinad hospital. The study was conducted during a time period of 1 year (May 2019 to May 2020).Results: The medical complications and underlying causes for BOH were analysed among the study group. Out of 41 women, 6 were diagnosed to have gestational diabetes mellitus (GDM), 8 were found to be hypertensive and 1 APLA positive. Neonatal mortality was encountered in 2 cases, attributing to Inborn error of metabolism. However, the cause for BOH remained unexplained in 3 individuals.Conclusions: A full work-up can be initiated after two consecutive losses to identify and treat the various causes responsible for BOH. Lot of further studies and research are being conducted to unravel the mystery in these cases. Despite these efforts, the male factors contributing to recurrent pregnancy loss have remained largely unexplored.


2020 ◽  
Vol 10 (01) ◽  
pp. e118-e120 ◽  
Author(s):  
Anjali Mitra ◽  
Shelley Dolitsky ◽  
Stacy Yadava ◽  
Elena Ashkinadze

AbstractBased on the known carrier frequency of Smith–Lemli–Opitz's syndrome (SLOS), the prevalence of this disease should be significantly higher than what is observed in the population. This may be due to a higher rate of pregnancy loss in affected embryos. Here, we present the case of a couple who underwent expanded carrier screening (ECS) after experiencing three first trimester pregnancy losses. Both parents were found to be carriers of SLOS mutations, and DNA analysis of the fetal remains of the third loss revealed the aborted fetus had inherited both the maternal and paternal mutations. This suggests SLOS as a reason for this patient's recurrent pregnancy loss (RPL), and therefore, ECS should be considered as part of the RPL work-up.


1970 ◽  
Vol 2 (2) ◽  
pp. 29-35
Author(s):  
Mst Rashida Begum ◽  
Mariya Ehsan ◽  
Mst Sahina Begum ◽  
Hosne Ara Baby ◽  
Maruf Siddiqui ◽  
...  

Three or more consecutive pregnancy losses are considered as recurrent pregnancy loss (RPL). About 1% of all pregnant women face this distressing problem and o.5% to 5% of spontaneous abortions are recurrent. Genetic, environmental, anatomic, hormonal, infectious and immunological factors are associated with RPL. Sometimes several factors might simultaneously be responsible for RPL. So diagnostic work up is to be extended. Life style changes, hormonal supplementation, anticoagulant and immunotherapy and surgical correction of certain uterine anatomic defects might help the couple to be parent. Genetic problem can be overcome by pre-implantation genetic diagnosis (PGD) and transferring good healthy embryos. Key Words: Recurrent Pregnancy Loss (RPL); Pre Implantation Genetic Diagnosis (PGD) DOI: http://dx.doi.org/10.3329/akmmcj.v2i2.8170 AKMMC J 2011; 2(2): 29-35


Author(s):  
Sofie Bliddal ◽  
Nielsen Henriette Svarre ◽  
Aase Krogh-Rasmussen ◽  
Kolte Astrid Marie ◽  
Christiansen Ole Bjarne ◽  
...  

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