scholarly journals Successful outcome of pregnancy in bicornuate uterus: a case report

2019 ◽  
Vol 8 (10) ◽  
pp. 4086
Author(s):  
Suman Choudhary ◽  
Prasuna Jelly ◽  
Prakash Mahala
Keyword(s):  
Pregnancy Loss ◽  
Recurrent Pregnancy Loss ◽  
Transvaginal Ultrasound ◽  
Successful Outcome ◽  
Missed Abortion ◽  
Septate Uterus ◽  
Bicornuate Uterus ◽  
Unicornuate Uterus ◽  
Uterine Growth ◽  
History Of

Bicornuate uterus is a major cause of spontaneous abortion. The recurrent pregnancy loss has been reported to the range of 15% to 27%. There is different type of congenital uterine abnormalities like Bicornuate uterus, septate uterus, arcuate uterus, unicornuate uterus, didelphys uterus. It is important to consider this diagnosis in recurrent miscarriages, malpresentation, intra uterine growth restrictionand preterm deliveries. This report is about self at the age of 25-year-old pregnancy with a history of missed abortion. I was not diagnosing with a bicornuate uterus in my first pregnancy. However, I was diagnosed with a bicornuate uterus based on transvaginal ultrasound and hysterosalpingogram. A successful caesarean section was donein the 38th week of gestation. According to the results, successful outcome could be achieved with bicornuate uterus. The outcome of bicornuate uterus was successful.

scholarly journals Pregnancy in bicornuate uterus

2017 ◽  
Vol 7 (1) ◽  
pp. 346
Author(s):  
D. Borgohain ◽  
Shubhi Srivastava
Keyword(s):  
Successful Outcome ◽  
Septate Uterus ◽  
Bicornuate Uterus ◽  
Unicornuate Uterus ◽  
Mesonephric Duct ◽  
Embryonic Life ◽  
History Of ◽  
Uterine Malformations ◽  
The Subject ◽  
Growth Restrictions

The incidence of the uterine malformations is estimated to be 3% to 5% in the general population. Abnormal fusion of the mesonephric duct (Mullerian duct) during embryonic life results in a variety of congenital uterine malformations like septate uterus, unicornuate uterus, and bicornuate uterus. Fertility and evolution of pregnancy depends on the type of uterine anomaly. Many of them are asymptomatic but it is important to consider this diagnosis in recurrent miscarriages, preterm labours, malpresentations, and intrauterine growth restrictions. We are presenting a 22-years-old pregnant woman with a history of abortion. The patient was not diagnosed with a bicornuate uterus in her first pregnancy. However, she was diagnosed with a bicornuate uterus based on the findings of ultrasound in the present pregnancy. A successful caesarean section was performed on the subject in the 39th week of gestation. According to the results, successful outcome could be achieved in patients with bicornuate uterus.

Consultative Hematology: The Pregnant Patient Pregnancy Loss

Hematology ◽  
2010 ◽  
Vol 2010 (1) ◽  
pp. 166-172 ◽  
Author(s):  
Shannon M. Bates
Keyword(s):  
Antithrombotic Therapy ◽  
Pregnancy Loss ◽  
Recurrent Pregnancy Loss ◽  
Pregnant Patient ◽  
Quality Data ◽  
Successful Outcome ◽  
Pregnancy Failure ◽  
Increased Risk ◽  
History Of ◽  
Good Quality Data

Abstract The presence of antiphospholipid antibodies has been associated with an increased risk of recurrent pregnancy loss, and there is evidence to suggest that antithrombotic therapy improves the likelihood of a successful outcome in affected women. Recent studies suggest an association between hereditary thrombophilia and pregnancy loss, although a causal role remains controversial. Although the available data are limited and flawed, there is increasing use of antithrombotic therapy in thrombophilic women with a history of pregnancy failure. Given the absence of proven effective therapy in women with unexplained recurrent loss, there is also growing pressure to intervene with antithrombotics in women with no known underlying thrombophilia. This article reviews the evidence for an association between thrombophilia and recurrent pregnancy loss and the data regarding the use of antithrombotic therapy for prevention of loss—an area that remains particularly challenging because of the paucity of good quality data upon which to base clinical decisions.

scholarly journals A CASE OF FUNCTIONING NON COMMUNICATING RUDIMENTARY HORN WITH UNICORNUATE UTERUS: AN UNUSUAL CAUSE OF SECONDARY DYSMENORRHEA IN A PERIMENOPAUSAL WOMAN.

2020 ◽  
pp. 141-142
Author(s):  
Pushpalatha K ◽  
Patel Shweta ◽  
Pagare Priyanka ◽  
Sharma Tanya
Keyword(s):  
Pregnancy Loss ◽  
Recurrent Pregnancy Loss ◽  
Adnexal Mass ◽  
Incomplete Fusion ◽  
Imaging Studies ◽  
Rudimentary Horn ◽  
Unicornuate Uterus ◽  
Uterine Malformation ◽  
History Of ◽  
Secondary Dysmenorrhea

Mullerian duct malformations represent a miscellaneous group of congenital anomalies that result from the arrested development, abnormal formation or incomplete fusion of the paramesonephric ducts. Congenital Mullerian abnormalities usually present at adolescent age with menstrual irregulari¬ty, dysmenorrhea, infertility and recurrent pregnancy loss. The Unicornuate uterus is a rare uterine malformation which usually features a rudimentary accessory horn with or without functioning endometrium. We are presenting a case of perimenopausal multiparous patient who had history of secondary dysmenorrhea diagnosed with endometrioma on imaging studies, but on laparotomy incidentally found to have Unicornuate uterus with functioning noncommunicating rudimentary horn leading to hematometra and hematosalpinx. The objective of this clinical case report is to highlight this rare Mullerian malformation as a differential diagnosis of secondary dysmenorrhea, chronic pelvic pain or adnexal mass in perimenopausal age group females.

O-139 Complete removal of uterine septum tissue as a wedge, an alternative method for patients suffering from recurrent pregnancy loss or infertility, a retrospective cohort study

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
F Razzaghi Kashani ◽  
R Zargham ◽  
S Amirajam ◽  
H Jadda ◽  
S Razi ◽  
...  
Keyword(s):  
Embryo Transfer ◽  
Retrospective Cohort ◽  
Pregnancy Loss ◽  
Recurrent Pregnancy Loss ◽  
Recurrent Miscarriage ◽  
Complete Removal ◽  
Septate Uterus ◽  
History Of ◽  
Uterine Septum

Abstract Study question Is hysteroscopic wedge septectomy (HWS) an effective and safe method for reducing the risk of miscarriage and improving the reproductive outcome in patients with recurrent pregnancy loss or infertility history? Summary answer HWS is a safe and effective method for RPL and infertility cases with statistically significant improvement in pregnancy chances and reproductive outcomes. What is known already With regard to the persisting uncertainty around the effectiveness of septum resection in recurrent miscarriage and infertility cases, there may be alternative methods to better address the pathophysiology of septum. There are different explanations for the poor reproductive performance with uterine septum: poor vascularisation of a highly fibrous implantation site, low sensitivity of endometrial receptors covering the septa, its “myoma-like” composition, and finally higher uterine vascular resistance. Complete removal of this abnormal tissue rather than just incising it may not only enhance challenging the pathogenesis but also expand the endometrial volume, an objective parameter by which to predict endometrial receptivity. Study design, size, duration In this retrospective cohort study, 214 consecutive patients, aged 33.3±4.8, diagnosed with a septate uterus based on ESHRE classification who had been under HWS between April 2017 and January 2020 due to recurrent miscarriage or at least one failed embryo transfer, met the enrollment criteria. With 11 to 36 months follow up, gathering of follow up data was managed between August till the end of Nov 2020, when the last new information was included. Participants/materials, setting, methods Patients with a history of RPL or at least one failed ET who were diagnosed as septate uterus by 2D, 3D, or hysteroscopy have been under HWS in a tertiary infertility and recurrent abortion treatment/educational setting. Those with BMI≥32, day 3 FSH≥13 mIU/mL, acquired or hereditary thrombophilia, thyroid disease, and myomatous uterus were excluded. HWS’s goal was to remove the septum as a wedge, cutting with 7Fr scissors, in its entirety as much as possible. Main results and the role of chance 39 patients who experienced 1 to 8 failed ET and 175 with 2 to 10 miscarriages, were enrolled in the study. The average septum size based on the depth of the removed wedge was 1.73±0.86 cm. There was an increase of 1.68±0.9 cm in uterine depth and 2.28±0.6 ml in uterine capacity measured by uterine sound and inflation of 8F Folley catheter balloon inside the cavity, respectively. The procedure took 35.75±8.7 minutes. Intraoperative, postoperative, or late complications during the next pregnancies were not reported. 7 patients (17.9%) in failed ET group, conceived spontaneously, before another embryo transfer attempt. Embryo transfer in the remaining 32 cases resulted in 25 (78.1%) clinical pregnancies. 2 miscarried (6.2%), 5(15.6%) are ongoing after 20 weeks of gestation and 25 (78.1%) have resulted in live births. Among 126 clinical pregnancies in RPL group, 16 patients (12.6%) experienced another miscarriage; 6%, 11.3%, and 25% in patients with a previous history of 2, 3, and 4 or more miscarriages, respectively. There was a significant drop in odds of post-procedure miscarriage from 22.7% to 6% (p:0.005) and from 27.8% to 11.3% (p:0.27) with 2 and 3 miscarriage history, respectively. This reduction was not significant with more than 3 losses. Limitations, reasons for caution We acknowledge the inherent limitations of this retrospective observational study, confining direct inferences. Our goal is to encourage future prospective studies to compare the effectiveness of different methods of hysteroscopy with or without involving the removal of septal tissue. An RCT comparing metroplasty vs expectant management seems infeasible, though. Wider implications of the findings Our findings suggest that timely removal of the uterine septal tissue with hysteroscopy will result in favorable reproductive outcomes in patients with RPL and/or infertility. Also, a history of a normal term pregnancy before subsequent successive losses does not rule out the uterine septum and calls for a thorough assessment. Trial registration number not applicable

scholarly journals Investigating Association of rs5918 Human Platelets Antigen 1 and rs1800790 Fibrinogen β Chain as Critical Players with Recurrent Pregnancy Loss

2018 ◽  
Vol 6 (4) ◽  
pp. 98 ◽  
Author(s):  
Fatemeh Karami ◽  
Maliheh Askari ◽  
Mohammad Modarressi
Keyword(s):  
Pregnancy Loss ◽  
Recurrent Pregnancy Loss ◽  
Human Platelets ◽  
P Value ◽  
Increased Risk ◽  
History Of ◽  
Polymerase Chain ◽  
Β Chain ◽  
Larger Sample

Thrombophilia gene variants have been shown to be associated with higher risk of recurrent pregnancy loss (RPL). Due to the role of human platelets antigen 1 (HPA-1) and fibrinogen β chain (FGB) as critical players in the coagulation process, their most important variants including rs5918 T > C and rs1800790 G > A were selected to be studied in women affected by RPL. Three milliliters of peripheral blood were drawn from 110 women with history of at least two consecutive spontaneous abortion and 110 healthy women controls. rs5918 T > C and rs1800790 G > A of HPA-1 and FGB genes, respectively, were selected to be analyzed through polymerase chain reaction-restriction fragment length polymorphism (PCR_RFLP) following DNA isolation using QIAamp DNA Blood Mini Kit. Heterozygote genotype (TC) of HPA-1 gene rs5918 polymorphism was significantly associated with risk of RPL (p-value = 0.02). Although, rs1800790 G > A of FGB gene was not associated with RPL, its combination with rs5918 polymorphism was associated with increased risk of RPL. Owing to the critical roles of FGB and HPA-1 genes in coagulation, and thrombosis and several confinements on the meaningful association between the combination of those polymorphism with risk of RPL, including them in the thrombophilia panel may increase detection rate of hereditary thrombophilia patients. However, further studies with larger sample sizes are required to shed light on the exact role of the studied gene polymorphism, especially rs1800790 G > A of FGB gene variant in pathogenesis of RPL.

scholarly journals Puzzle Out the Reason behind Habitual Miscarriage

2020 ◽  
pp. 92-98
Author(s):  
Waqas Ahmad ◽  
Shahid Bilal ◽  
Sarah Azhar ◽  
Muhammad Aitmaud Uddolah Khan ◽  
Nasima Iqbal ◽  
...  
Keyword(s):  
Risk Factors ◽  
Maternal Age ◽  
Pregnancy Loss ◽  
Recurrent Pregnancy Loss ◽  
Multinomial Logistic Regression ◽  
Strong Association ◽  
Multinomial Logistic Regression Model ◽  
Multiple Risk Factors ◽  
Bivariate Correlation ◽  
History Of

Aims: As no data is available in Pakistan so the aim of current study is to find out the link of multiple risk factors with recurrent pregnancy loss (RPL) in Pakistan. Study Design: Case control study. Place and Duration of Study: Study conducted in Obstetrics and Gynecology Clinic of Benazir Bhutto Hospital, Holy Family Hospital Rawalpindi and Polyclinic Hospital Islamabad from November 2018 to April 2019. Methodology: Subjects were investigated on the basis of an in depth Performa. For data analysis Statistical package for social sciences version-20 was used. Beside this, height in cm, weight in kg and blood pressure in mmHg were recorded. All the statistical calculations were performed by using SPSS 20. For association analysis of qualitative variables Spearman bivariate correlation was calculated while for numerical variables ANOVA was applied. Multinomial logistic regression model was used and the odd ratio and relative risk were calculated. Results: Among cases 91.34% were having spontaneous miscarriage and majority (64.86%) were during first trimester. Spearman bivariate correlation reported a strong association of recurrent pregnancy loss with the risk factors including family history, smoking, obesity, history of hypertension and history of diabetes, having highly significant p-values, on the hand, significant association of maternal age with the frequency of recurrent pregnancy loss was found but not with the paternal age and parity. The multinomial logistic regression model showed that smokers were19.012 times more prone to develop recurrent pregnancy loss. Conclusion: The multiple risk factors including maternal age, obesity, smoking, family history, body mass index, hypertension and diabetes have a strong association with the recurrent pregnancy loss. So keeping these risk factors in mind a careful evaluation of each pregnancy is necessary to reduce the risk of recurrent pregnancy loss.

scholarly journals Endometrial evaluation with methylene blue staining in patients with normal hysteroscopy

2019 ◽  
Vol 8 (7) ◽  
pp. 2715
Author(s):  
Alka Goel ◽  
Pooja Gupta ◽  
Akansha Singh ◽  
Khushboo Singh
Keyword(s):  
Methylene Blue ◽  
Pregnancy Loss ◽  
Recurrent Pregnancy Loss ◽  
Blue Staining ◽  
False Negatives ◽  
Normal Endometrium ◽  
Significant Difference ◽  
History Of ◽  
Dark Blue

Background: Normally, endometrium comprises of non-absorptive epithelium and does not take up stain. Conventional staining with methylene blue is explained on the basis of existence of apoptotic cells in endometrium.Methods: Of 50 patients of unexplained infertility, AUB, recurrent pregnancy loss were randomly selected and included in the study. Those with abnormal ultrasound and history of tuberculosis were excluded. Conventional hysteroscopy was performed using normal saline as distending medium and in those with grossly normal endometrium were subjected to staining with 5% methylene blue instilled trans cervically. After 5 min, irrespective of the size and pattern, focal dark blue stained areas were considered abnormal and randomly biopsied. Incidence of endometritis in both groups was compared after histopathological examination.Results: Of total 50 patients, histopathological report of only one patient with dark blue staining had evidence of endometritis. Rest had no evidence, of which 73.5% had light blue or unstained areas and 26.5% showed dark blue staining. No statistically significant difference was found between histopathological reports and light or dark blue staining (p=0.28). When percentage stained area was considered more than 50% only to be positive, sensitivity was 100%, specificity 94%, PPV 25% and NPV 100%. False positives were 75% and no false negatives were observed. Although p values improved but still statistically insignificant.Conclusions: Present study failed to establish any significant correlation between staining pattern and detection rate of endometritis. With no Indian studies published on chromohysteroscopy so far, role of methylene blue in detection of subtle endometrial changes in modern gynaecology in Indian subpopulation is yet to be established.

scholarly journals Association Study between the Polymorphisms of Matrix Metalloproteinase (MMP) Genes and Idiopathic Recurrent Pregnancy Loss

Genes ◽  
2019 ◽  
Vol 10 (5) ◽  
pp. 347 ◽  
Author(s):  
Han Sung Park ◽  
Ki Han Ko ◽  
Jung Oh Kim ◽  
Hui Jeong An ◽  
Young Ran Kim ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Odds Ratio ◽  
Pregnancy Loss ◽  
Adjusted Odds Ratio ◽  
Recurrent Pregnancy Loss ◽  
Proteolytic Enzymes ◽  
Nucleotide Polymorphisms ◽  
Genotype Combination ◽  
History Of ◽  
Consecutive Pregnancy

Recurrent pregnancy loss (RPL) refers to two or more consecutive pregnancy losses. It is estimated that fewer than 5% of women experience RPL. Matrix metalloproteinases (MMPs) are a family of proteolytic enzymes that play important roles in providing a safe and conducive environment for the stable development of the fetus. In this case-control study, we evaluated the associations between RPL and single nucleotide polymorphisms (SNPs) in MMP-8 and MMP-27. We recruited 375 Korean women with a history of RPL and 240 ethnically-matched healthy parous controls, and we performed genotyping for the MMP-8 rs2509013 C>T, MMP-8 rs11225395 G>A, and MMP-27 rs3809017 T>C polymorphisms. All SNPs were genotyped via the polymerase chain reaction–restriction fragment length polymorphism (PCR-RFLP) assay. In the genotype frequency analyses, the TT genotype of the MMP-8 rs2509013 C>T (age-adjusted odds ratio, 0.415; 95% confidence interval, 0.257–0.671; P = 0.0003) and TC genotype of MMP-27 rs3809017 T>C (age-adjusted odds ratio, 0.681; 95% confidence interval, 0.483–0.961; P = 0.029) were associated with decreased RPL susceptibility. Moreover, these trends were maintained in the haplotype and genotype combination analyses. Interestingly, amongst the RPL patients, higher levels of homocysteine (P = 0.042) and uric acid (P = 0.046) were associated with MMP-27 rs3809017 T>C. In conclusion, the two polymorphisms of MMP-8 and MMP-27 were significantly associated with RPL risk, both individually and in combination. Therefore, these two polymorphisms are potential biomarkers for RPL susceptibility.

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