scholarly journals Modified Laparoscopic Transabdominal Cervicoisthmic Cerclage for the Surgical Management of Recurrent Pregnancy Loss due to Cervical Factors

2021 ◽  
Vol 10 (4) ◽  
pp. 693
Author(s):  
Hyewon Chung ◽  
Seungmee Lee ◽  
Changho Song ◽  
Tae-Kyu Jang ◽  
Jin-Gon Bae ◽  
...  
Keyword(s):  
Pregnancy Loss ◽  
Recurrent Pregnancy Loss ◽  
Operation Time ◽  
Obstetric Outcomes ◽  
Fetal Survival ◽  
History Of ◽  
Observational Cohort ◽  
The Mean ◽  
Retrospective Observational Cohort Study ◽  
Present Pregnancy

This study aimed evaluate the feasibility of modified laparoscopic transabdominal cervicoisthmic cerclage (LTCC) and its impact on recurrent pregnancy loss (RPL) and is a retrospective observational cohort study of patients who underwent modified LTCC from 2003 to 2018 (n = 299). The surgery was performed at a mean gestational age of 12.5 weeks (range 10.5–17.5 weeks). Of the 299 patients, 190 were reported as having undergone abortion (one abortion: 91 (47.9%), two: 59 (31.1%), three or more: 40 (21.1%)) before the present pregnancy and prior to the surgery. The mean operation time was 47.4 min (range 15–100 min). We followed up with 205 of 299 patients and recorded their obstetric outcomes. There were 176 successful deliveries via cesarean section, and the fetal survival rate was 85.9% (176/205). The results of this study suggest that modified LTCC is a safe and feasible surgical option during pregnancy for patients with a history of RPL due to cervical factors.

scholarly journals Dysmorphic Uteri: Obstetric Results after Hysteroscopic Office Metroplasty in Infertile and Recurrent Pregnancy Loss Patients. A Prospective Observational Study

2020 ◽  
Vol 9 (9) ◽  
pp. 2857
Author(s):  
Mónica Sánchez-Santiuste ◽  
Mar Ríos ◽  
Laura Calles ◽  
Reyes de la Cuesta ◽  
Virginia Engels ◽  
...  
Keyword(s):  
Live Birth ◽  
Pregnancy Loss ◽  
Birth Rate ◽  
Recurrent Pregnancy Loss ◽  
Live Birth Rate ◽  
Obstetric Outcomes ◽  
Significant Difference ◽  
History Of ◽  
The Difference ◽  
Infertile Patients

To compare the obstetric results achieved after hysteroscopic office metroplasty (HOME-DU) in infertile and recurrent pregnancy loss (RPL) patients diagnosed with dysmorphic uterus, women hysteroscopically diagnosed with dysmorphic uterus who underwent uterine-enlargement metroplasty were prospectively enrolled from June 2016 until April 2020. Patients were followed up and obstetric outcomes were recorded (pregnancy and live birth rate). Sixty-three women (30 infertile; 33 RPL) were enrolled, of which 48 became pregnant post-HOME-DU, with an overall pregnancy rate of 76.2% (66.7% among infertile participants; 84.9% among those with RPL). Overall, 64.3% (n = 36/63) achieved live birth. Among infertile women, 62.07% (n = 18/29) achieved live birth, as well as 66.7% of women with RPL (n = 18/27). The difference in live birth rates between both cohorts was 4.6% (p > 0.05). The rate of miscarriage amongst infertile patients was 3.3% (n = 1/30) and 12.1% amongst women with RPL (n = 4/33). Office metroplasty via the HOME-DU technique improves obstetric results (namely increasing live birth rate) in patients with dysmorphic uterus and a history of reproductive failure. No significant difference was found in the clinical efficacy of HOME-DU in infertile and RPL patients.

scholarly journals Thyroid Autoimmunity is a Risk Factor for Recurrent Pregnancy Loss

2018 ◽  
Vol 30 (1) ◽  
pp. 49-55
Author(s):  
Sharmin Sultana ◽  
Mosammat Nargis Shamima ◽  
Sahela Jesmin ◽  
Nargis Zahan ◽  
Md Abu Zahid ◽  
...  
Keyword(s):  
Risk Factor ◽  
Pregnant Women ◽  
Pregnancy Loss ◽  
Recurrent Pregnancy Loss ◽  
Recurrent Miscarriage ◽  
Control Group ◽  
Genital Organ ◽  
Thyroid Antibodies ◽  
History Of ◽  
The Mean

This was a hospital based case control study. The study included patients attending in outdoor and indoor Department of Obstetrics and Gynaecology of Rajshahi Medical College, Hospital since July 2014 to June 2016. The aim of this study was to determine thyroid antibodies is a risk factor for recurrent pregnancy loss. Sixty seven pregnant or non pregnant women with history of recurrent miscarriage during 1st trimester were selected as case group and another sixty seven pregnant women who reached their 12 weeks uneventfully with no history of recurrent miscarriage were selected as control group. Patients with other cause of recurrent miscarriage such as metabolic or endocrinologic disorders, genital organ anomaly, uterine fibroid were excluded from the study. Thyroid function test and thyroid antibodies (FT4, TSH and TPO-Ab) were measured for the two groups. The result of this study showed that the percentage of positive TPO-Ab in target and control group is 67.16% and 5.95% respectively. The study observed that the mean serum concentrations of FT4 in the control subject was significantly higher than the mean of the target group (p-value <0.05). The TSH concentration was increased in miscarriage women with positive antibodies compared with the concentration of TSH in the control group with positive antibodies. The conclusions are that there is a deficiency in thyroid hormones or thyroid’s functional capacity is unable to meet the extra demands of pregnancy which may be one of the causes of recurrent miscarriage. Moreover positive thyroid antibodies pregnant women can reach term and have babies when the concentration of TSH is low during the first trimester, so the risk of miscarriage could be high in positive thyroid antibodies.TAJ 2017; 30(1): 49-55

scholarly journals Thyroid Disorders in Pregnancy and Prevalence of Subclinical Hypothyroidism in Recurrent Early Pregnancy Losses

2021 ◽  
Vol 15 (8) ◽  
pp. 2366-2369
Author(s):  
Mehwish Younus ◽  
Urooj Yasir Khan ◽  
Urooj Naz ◽  
Aruna Kumari Hira ◽  
Sana Shahmir ◽  
...  
Keyword(s):  
Gestational Age ◽  
Pregnancy Loss ◽  
Recurrent Pregnancy Loss ◽  
Venous Blood ◽  
Thyroid Stimulating Hormone ◽  
Free T4 ◽  
Cross Sectional ◽  
History Of ◽  
The Mean ◽  
Thyroid Profile

Objective: Determine the frequency of hypothyroidism in recurrent pregnancy loss. Study Design: This is cross sectional. Place and Duration of Study: This study was conducted at Obstetrics and Gynaecology department of Dow Medical University & Hospital, Ojha Campus, Karachi, from 7th July 2018 to 6th July 2019. Methodology: This study was conducted on 83 patients. Detailed history was taken from all the patients with special regard to demographics like age, parity and recurrent pregnancy loss. A 3 ml venous blood was drawn by the staff on duty and sent to institutional laboratory for TSH and free T4 level. TSH values more than 4.5 μIU/L and normal free T4 level (0.7 to 1, 8 ng/ml) were considered as hypothyroidism. All pregnant female was between age 20-35 years with > 6 months gestational age and history of parity 3 and gravida 4 were included in the study. Exclusion criteria were known case of hypothyroidism or history of taking medication for hypothyroidism, history of Hypertension and DM. Results: This study was conducted on 83 patients. There was wide variation of age ranging from a minimum of 20 years to 35 years. The mean age was 28.4+ 4.49 years. Mostly patients were parity 3 and gravid 4 in 55(66.26%) cases followed by parity 4 and gravid 4 in 28(33.73%) cases. Gestational age was measured on ultrasound ranging from 8 weeks to 22 weeks. The mean gestational age was 14.20+4.71 years. Patient's thyroid profile mean Thyroid-stimulating hormone (TSH) level was 2.39+1.66 mU/L, mean free T4 was 17.23+6.41 nmol/L and mean free T3 was 4.87+1.18 μmol/L. Observed hypothyroidism was in 11(13.3%) cases while rest of 72(86.7%) cases within normal range. Conclusion: We concluded that hypothyroidism is problem in recurrent pregnancy loss. 11(13.3%) cases Frequency of hypothyroidism in women with pregnancy, the possible role of thyroid functional disorders in etiology of at least some part of recurrent pregnancy loss, had emphasized the importance of thyroid functions tests screening as routine in all pregnancies. Keywords: Thyroid disease, Pregnancy outcome, Hypothyroidism.

Obstetric outcomes of recurrent pregnancy loss patients diagnosed wıth inherited thrombophilia

2017 ◽  
Vol 186 (3) ◽  
pp. 707-713 ◽  
Author(s):  
C. Karadağ ◽  
T. Yoldemir ◽  
S. D. Karadağ ◽  
C. İnan ◽  
Z. N. Dolgun ◽  
...  
Keyword(s):  
Pregnancy Loss ◽  
Recurrent Pregnancy Loss ◽  
Obstetric Outcomes ◽  
Inherited Thrombophilia

Obstetric Outcomes after Recurrent Pregnancy Loss

2020 ◽  
pp. 172-183
Author(s):  
Rakefet Yoeli-Ullman ◽  
Howard J.A. Carp ◽  
Shali Mazaki-Tovi
Keyword(s):  
Pregnancy Loss ◽  
Recurrent Pregnancy Loss ◽  
Obstetric Outcomes

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.

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