scholarly journals Recurrent pregnancy loss: challenge to obstetricians

2017 ◽  
Vol 6 (8) ◽  
pp. 3376
Author(s):  
Mamatha B. Shetty ◽  
Mounica Malyala ◽  
Asha Swarup ◽  
Suneha Pocha ◽  
Davis Sabu Pathadan ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Pregnancy Loss ◽  
Recurrent Pregnancy Loss ◽  
Recurrent Miscarriage ◽  
Laboratory Data ◽  
Difficult Situation ◽  
Live Births ◽  
Medical College ◽  
Cervical Incompetence ◽  
Study Results

Background: Recurrent pregnancies loss (RPL) is physically and emotionally devastating situation for the parents, along with difficult situation for obstetrician to handle. Present study aimed at investigation of the significance of various etiology in relation to pregnancy outcome in cases of recurrent pregnancy loss.Methods: It is a retrospective analysis of patients who presented to M. S. Ramaiah Medical college with recurrent miscarriage between April 2014 and August 2015. ANA was done on the basis of clinical and laboratory data which was obtained and eventually diagnosis was made. The study results were analysed in terms of term live births, maternal and fetal complications.Results: Out of the RPL cases that were studied, 78 patients came with recurrent pregnancy loss. Out of these cases, endocrine abnormalities, like diabetes mellitus and hypothyroidism were the maximum 26.92% and 12.82% respectively. Followed by unexplained causes were 37.3%. Thrombophila and APLA positive cases constituted for 16.66% and 3.4% respectively. ANA positive and cervical incompetence were 6.4% each.Conclusions: Recurrent pregnancy loss is very difficult situation to handle. Various etiology need various specialists, and requirements, and management mainly depends on the cause for recurrent pregnancy loss.

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

Abstract 14592: Pregnancy Loss and Cardiovascular Disease Risk Factors in Early Adulthood: Preliminary Findings From Add Health

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Yamnia I Cortes ◽  
Shuo Zhang ◽  
Diane C Berry ◽  
Jon Hussey
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Risk Factor ◽  
Pregnancy Loss ◽  
Recurrent Pregnancy Loss ◽  
Early Adulthood ◽  
Add Health ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Live Births

Introduction: Pregnancy loss, including miscarriage and stillbirth, affect 15-20% of pregnancies in the United States annually. Accumulating evidence suggests that pregnancy loss is associated with greater cardiovascular disease (CVD) burden later in life. However, associations between pregnancy loss and CVD risk factors in early adulthood (age<35 years) have not been assessed. Objective: To examine associations between pregnancy loss and CVD risk factors in early adulthood. Methods: We conducted a secondary data analysis using the public-use data set for Wave IV (2007-2009) of the National Longitudinal Study of Adolescent to Adult Health (Add Health). Our sample consisted of women, ages 24-32 years, with a previous pregnancy who completed biological data collection (n=2,968). Pregnancy loss was assessed as any history of miscarriage or stillbirth; and as none, one, or recurrent (≥2) pregnancy loss. Dependent variables included physical measures and blood specimens: body mass index (BMI), blood pressure, diabetes status, and dyslipidemia. Associations between pregnancy loss and each CVD risk factor were tested using linear (for BMI) and logistic regression adjusting for sociodemographic factors, parity, pre-pregnancy BMI, smoking during pregnancy, and depression. Results: Six hundred and ninety-three women (23%) reported a pregnancy loss, of which 21% reported recurrent pregnancy loss. Women with all live births were more likely to identify as non-Hispanic White (73%) and report a higher annual income. After adjusting for sociodemographics (age, race/ethnicity, education, income), pregnancy loss was associated with a greater BMI (ß=0.90; SE,0.39). In fully-adjusted models, women with recurrent pregnancy loss were more likely to have hypertension (AOR, 2.50; 95%CI, 1.04-5.96) and prediabetes (AOR, 1.93; 95%CI. 1.11-3.37) than women with all live births; the association was non-significant for women with one pregnancy loss. Conclusions: Pregnancy loss is associated with a more adverse CVD risk factor profile in early adulthood. Findings suggest the need for CVD risk assessment in young women with a prior pregnancy loss. Further research is necessary to identify underlying risk factors of pregnancy loss that may predispose women to CVD.

An evaluation of recurrent pregnancy loss

2017 ◽  
Vol 6 (4) ◽  
pp. 1332 ◽  
Author(s):  
Abha Singh ◽  
Avinashi Kujur ◽  
Kalpana Rathore
Keyword(s):  
Pregnancy Loss ◽  
Genetic Factors ◽  
Recurrent Pregnancy Loss ◽  
First Trimester ◽  
Medical College ◽  
Antenatal Counseling ◽  
History Of ◽  
Immunological Factors ◽  
The Times ◽  
Loving Care

Background: This study was aimed to know the demographic profile and categorizes the causes of RPL.Methods: This observational study was carried out in the department of obstetrics and gynecology, Pt. J.N.M. Medical College Raipur from Nov 2015-Sept 2016. Total 100 women were evaluated with history of RPL.Results: 100 women were recruited in our study. The incidence of primary RPL was more than secondary RPL. 48 % women had first trimester abortions. The identifiable causes accounted for 53% out of which anatomical defects were the commonest .Next were endocrinal factors (20%), and Genetic factors (1%),Immunological factors 7%., Medical causes were 3%. However, 47% were unexplained.Conclusions: Despite innumerable investigations, sometimes or rather most of the times, the etiology remains obscure. It is this group of women who become a challenge to manage. Ultimately, most effective therapy for women with unexplained RPL is antenatal counseling, psychological support and tender loving care.

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 Increased expression of pentraxin 3 in placental tissues from patients with unexplained recurrent pregnancy loss

2019 ◽  
Vol 22 (1) ◽  
pp. 21-28 ◽  
Author(s):  
S Zeybek ◽  
E Tepeli ◽  
GO Cetin ◽  
V Caner ◽  
H Senol ◽  
...  
Keyword(s):  
Inflammatory Response ◽  
Pregnancy Loss ◽  
Recurrent Pregnancy Loss ◽  
Pentraxin 3 ◽  
Specific Expression ◽  
Expression Levels ◽  
Messenger Ribonucleic Acid ◽  
Live Births ◽  
Protein Levels ◽  
Mrna And Protein Expression

AbstractPentraxin 3 (PTX3), a prototypical member of the long pentraxin subfamily, is a evolutionarily conserved multimeric pattern recognition receptor involved in the humoral component of the innate immune system. Pentraxin 3 is released when tissue is stressed or damaged, and interacts with many different ligands. Pentraxin 3 exerts a pivotal role both as a regulator and as an indicator of inflammatory response in the pathogenesis of many diseases such as sepsis, vasculitis and preeclampsia. Uncontrolled inflammatory response is considered a major cause of unexplained recurrent pregnancy loss (URPL). We determined the PTX3 messenger ribonucleic acid (mRNA) and protein expression levels in placentai tissues from 50 women with URPL, and made comparison with those in 50 age-matched control subjects. In quantitative real-time polymerase chain reaction (qRT-PCR) and immunohistochemistry analyses, PTX3 mRNA and protein levels, respectively, were significantly increased in URPL patients compared with their respective controls (p = 0.0001). Although no significant correlations were identified between PTX3 expression levels and clinical parameters such as maternal age, numbers of previous pregnancy losses, and gestational age at miscarriage, PTX3 mRNA expression was significantly higher in patients with no live births than in women with previous live births (p = 0.0001). Our study suggests that tissue-specific expression of PTX3 is associated with URPL. Further larger studies are required to determine whether PTX3 expression can be used as a biomarker to manage URPL in routine clinical practice.

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.

scholarly journals Experiences of Recurrent Pregnancy Loss Through the Perspective of United Arab Emirates Women: A Qualitative Study

2018 ◽  
Vol 7 (3) ◽  
pp. 306-312
Author(s):  
Fatima Muhammad Ibrahim ◽  
Shamsa Abdulmanan Abdul Rahman Al Awar ◽  
Nahid Dehghan Nayeri ◽  
Moamar Al-Jefou ◽  
Fahimeh Ranjbar ◽  
...  
Keyword(s):  
Qualitative Study ◽  
United Arab Emirates ◽  
Religious Beliefs ◽  
Pregnancy Loss ◽  
Recurrent Pregnancy Loss ◽  
Recurrent Miscarriage ◽  
Health Clinic ◽  
Preventative Measures ◽  
Medical University

Objectives: The aim of this study was to evaluate the perception and experience of recurrent pregnancy loss through the perspective of women in the United Arab Emirates (UAE). Materials and Methods: This qualitative study was conducted in 2017 and 12 women with recurrent miscarriage were interviewed, using purposive sampling method, in the Medical and Health Clinic of the Department of Obstetrics and Gynecology under the supervision of the UAE Medical University. Transcribed interviews were analyzed using conventional content analysis. Results: Data analysis led to the extraction of three main themes, including endless pregnancy, thirst for support and affirmation, and religious beliefs. Conclusions: Overall, the experience of recurrent miscarriage means endless pregnancy from Arab women’s perspective, which awakened a thirst for support and affirmation. In this regard, the utilization of religious beliefs greatly reduced their pain. Therefore, knowing the dangers and consequences of recurrent miscarriages in Arab women, adopting preventative measures, and improving the quality of care in these vulnerable women require special attention.

scholarly journals Thrombophilia gene mutations in relation to recurrent miscarriage

2018 ◽  
Vol 7 (3) ◽  
pp. 796 ◽  
Author(s):  
Tawfik Abdelsalam ◽  
Tarek Karkour ◽  
Magdy Elbordiny ◽  
Dina Shalaby ◽  
Ziad S. Abouzeid
Keyword(s):  
Pregnancy Loss ◽  
Recurrent Pregnancy Loss ◽  
Recurrent Miscarriage ◽  
Gene Mutations ◽  
Factor V Leiden ◽  
Mthfr C677t ◽  
Factor V ◽  
Total Prevalence ◽  
History Of ◽  
Prothrombin Gene

Background: Recurrent pregnancy loss is multifactorial involving clinical and biological risk factors. Evidence addressed the association of inherited thrombophilia with recurrent pregnancy loss and other serious pregnancy complications. However, the relation between thrombophilia associated gene mutations and adverse obstetric outcome is controversial and data in the literature are inconsistent. The aim of this study was to investigate the prevalence of thrombophilia associated gene mutations (factor V Leiden, prothrombin gene G20210A and methylene-tetrahydrofolate reductase MTHFR C677T) in relation to recurrent miscarriage.Methods: Case control study conducted on 200 women recruited from Elshatby Maternity Hospital clinics. The cases group included 100 women with history of three or more unexplained consecutive pregnancy losses, while 100 healthy age matched women with no history of recurrent miscarriages served as controls. Blood samples were collected from all women enrolled in the study for DNA extraction and genotype analysis. Factor V, prothrombin and MTHFR gene mutations were assayed based on polymerase chain reaction (PCR) and reverse-hybridization.Results: The prevalence of Factor V Leiden and prothrombin gene G20210A mutations did not differ significantly between cases and controls. However, MTHFR C667T mutations and the total prevalence of the three gene mutations were significantly increased in the patients group compared to controls (p=0.001, p=0.003 respectively). The prevalence of combined thrombophilia of Factor V Leiden and MTHFR C677T was significantly increased in the patients group compared to controls (p=0.032). Regarding homozygosity of each of the gene mutations, no homozygosity was detected in controls and heterozygotes were significantly increased in the patients group compared to homozygotes.Conclusions: MTHFR mutations and the total prevalence of the three gene mutations were significantly increased in the patients group compared to controls. There was a significant increase in the prevalence of combined thrombophilia (Factor V Leiden and MTHFR C677T) in the patients group compared to controls without involvement of prothrombin gene.

Contemporary Evidence-Based Approach to the Couple Experiencing Recurrent Pregnancy Loss: Standardizing Terminology, Testing, and Treatment

2018 ◽  
Author(s):  
Channing Burks ◽  
Mary D Stephenson ◽  
Danny J Schust
Keyword(s):  
Gestational Age ◽  
Pregnancy Loss ◽  
Recurrent Pregnancy Loss ◽  
Comprehensive Evaluation ◽  
Recurrent Miscarriage ◽  
First Trimester ◽  
Diagnostic Evaluation ◽  
Etiologic Factor ◽  
Evidence Based ◽  
Close Monitoring

The objective of this review is to highlight central issues relating to recurrent pregnancy loss (RPL), including use of updated terminologies, updated criteria for initiating an RPL evaluation, and an evidence-based standard diagnostic evaluation. RPL is a condition characterized by repeated spontaneous demise of pregnancy. It is a multifactorial disorder that affects approximately 5% of couples in the general population who are trying to have a child. RPL should be defined as two or more pregnancy losses at any gestational age; these do not necessarily need to be consecutive. As 50 to 70% of pregnancy losses of less than 10 weeks gestational age are due to random numeric chromosome errors, we recommend chromosome testing of miscarriage tissues with the second and all subsequent miscarriages less than 10 weeks gestational age. If the second pregnancy loss is “unexplained,” meaning that the chromosome content is euploid (46,XX of pregnancy origin, 46,XY, or a balanced structural chromosomal rearrangement), then an RPL diagnostic evaluation is indicated. Despite a comprehensive evaluation, approximately 40% of couples with RPL will not have a specific etiologic factor identified. In these couples, as with all couples experiencing RPL, empirical management with close monitoring and supportive care during the first trimester is associated with encouraging subsequent live birth rates.   This review contains 10 figures, 5 tables and 57 references Key words: factors associated with recurrent pregnancy loss, idiopathic recurrent pregnancy loss, miscarriage chromosome testing, nonvisualized pregnancy loss, pregnancy of unknown location, recurrent miscarriage, recurrent pregnancy loss

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