The Effect of Fat Emulsion Intralipid Infusion on Reproductive Outcome for Women with Unexplained First Trimester Habitual Abortion

Objectives: To study the effect of the use of intralipid in management of women suffering from unexplained first trimester habitual abortion. Methods: The study was a prospective cohort study, which conducted in Tanta university Hospital; Egypt. It included 93 women with history of two or more unexplained recurrent abortion in the first trimester. They were divided into three groups: group Ι received only intralipid, group II received low molecular weight heparin (LMWH) and low dose aspirin, and group III served as controls and received only saline as placebo. The patients were followed up until continuation of pregnancy into the second trimester. Occurrence of complication and pregnancy outcomes were evaluated. Results: Ninety three women were included. After treatment, more pregnancy continued into the second trimester, more live births and less numbers of abortions in group A and B in comparison with group C (p=0.008, 0.008 and 0.035) respectively. Maternal and neonatal outcomes were comparable in all studied regimens. Conclusions: Management of women with unexplained first trimester habitual abortion (before 14 weeks) with intralipid or LMWH with small dose of aspirin may increase the proportion of pregnancy continued into the second trimester, more live births and less numbers of abortions. However, LMWH is more superior to the intralipid but with more side effect.

MANAGEMENT OF RECURRENT PREGNANCY LOSS W.S.R PUTRAGHANI YONIVYAPADA WITH AYURVEDIC REGIMEN: A CASE STUDY

Background: A married Hindu female patient of 37 years of age visited to OPD of National institute of Ayurveda, Jaipur on 19 April 2019 with chief complaint of recurrent pregnancy loss since 7 years. Methodology: Patient was interrogated for detailed history about her chief as well as associated complaints. Following detailed history neces- sary physical examinations and laboratory investigations were carried out to rule out the aetiology. Her TORCH test IgG and IgM antibodies was carried out and she was found to have Rubella IgG, Cytomegalovirus IgG, and HSV IgG antibodies positive. Other investigations including TFT, PRL, USG scan was found to be normal. Based on the complaints diagnosis made was Putraghani Yonivyapada (Recurrent pregnancy loss or Habitual abortion). Treatment plan was laid out accordingly on the basis of complaints and etiological factors. She managed to conceive 6 months after the treatment. She was given proper antenatal care with all necessary examinations and advices. Result: She delivered a healthy male baby on 20th July 2020 without any event during her antenatal, perinatal and postnatal period. Keywords: Putraghani yonivyapada, Recurrent pregnancy loss, Habitual abortion

AYURVED APPROACH TO PUTRAGHNI YONIVYAPADA W.S.R. TO HABITUAL ABORTION DUE TO TORCH INFECTION: CASE STUDY

Pregnancy is the start of an incredible journey that leads to great emotional fulfilment to woman. Pregnancy loss is a physically and emotionally demanding for couples. Recurrent Pregnancy Loss (RPL) is also called as Recurrent Miscarriage or Habitual Abortion. It is defined as three consecutive pregnancy losses prior to 20weeks of pregnancy from the last menstrual cycle (LMP). Putraghni is a condition where repeated pregnancy loss occurs because of Artava dosha, Rakta dosha, Ati raktasrava. The article is to understand the Putraghni Yonivyapada w.s.r. to habitual abortion caused due to TORCH Infection and to study the effect of Ayurvedic medicines in the management of Putraghni Yonivyapada w.s.r. to habitual abortion caused due to TORCH Infection. The method is the single arm, open labelled case study of the subject of 27 yrs age having repeated pregnancy loss who has been treated with Shamana Chikitsa throughout pregnancy, Matrabasti and Yonipichu in 8th and 9th months. Pregnancy continued with treatment. Antenatal visits and Ultrasonography observations gave positive outcomes with healthy foetal growth. Patient delivered a full term single live male baby vaginally on 27/10/2019 at 3:20PM with 2.8kg. No birth anomalies were detected. The selected treatment protocol i.e., Shamana Aushadha, Matrabasti and Yonipichu in 8th and 9th month are found very effective in the management of Putraghni Yonivyapada w.s.r. to habitual abortion caused due to TORCH Infection.

NEW EARLY PROGNOSTIC CRITERIA FOR PREGNANCY OUTCOME IN WOMEN WITH RECURRENT MISCARRIAGE

To determine the new criteria for predicting the outcome of pregnancy in women with habitual abortion based on features of differentiation of naive T cells and memory cells in a population of T-helper (CD4+) and cytotoxic T lymphocytes (CD8+). The study involved 61 women with threatened and habitual abortion in the first trimester of gestation. Depending on the outcome of pregnancy was allocated to 3 groups: I went to 39 women whose pregnancy ended in timely delivery; in II - 10 women whose pregnancies ended in premature birth; in III - 11 patients in whom there was a spontaneous miscarriage. Using three-color flow cytometry as peripheral venous blood in populations of CD8+ and CD4+ determined by the content Tn, Tcm, Tem and Temra cells. Statistical analysis was carried out in the program «MicrosoftOffice 2010», «Statistica for Windows 6.0» and MedCalc». When conducting a retrospective assessment, it was found that in the group of patients whose pregnancy ended in preterm delivery, the percentage of CD4 + Tem memory cells was significantly higher and CD4 + Tn lower than in the subgroup with timely delivery (p = 0.013 and p = 0.025, respectively ) In patients with early spontaneous miscarriage, the level of CD8 + Tn significantly decreased against the background of the growth of CD8 + Tem memory cells compared with the same parameters in patients with timely delivery (p = 0.040 and p = 0.014, respectively). Prediction of spontaneous abortion is possible up to CD4+ Tn equal to 34.2% or less (sensitivity - 100.0%, specificity - 56.4%, accuracy - 63.8%), premature birth - if the CD4+ Tn equal to 35, 2% or less (sensitivity - 66.7%, specificity - 74.4% accuracy - 72.9%). Thus, the new criteria will allow additional time to identify risk and assign adequate treatment aimed at prolonging the desired pregnancy.