Diagnostic role of uterine artery dopplerometry in the first trimester of pregnancy

A Doppler sonographic examination of blood flow in the left and right uterine arteries was carried out in women in the first trimester of pregnancy. Systolic- diastolic ratio (S/D) andpulsative index (PI) were assessed in 71 women with physiological course of pregnancy and in 49 women with threatened abortion. The investigation revealed clear connection of the uterine blood flow lateralization and corpus luteum localization. These interrelations are characterized differently in case of physiological pregnancy and threatened abortion. The new approach to the evaluation of uterine blood flow gives an ability ofpreclinical diagnostics of threatened abortion.

Meta-analysis and randomized controlled studies: what clinicists should know to prevent regular and spontaneous miscarriages of unexplained genesis?

The etiopathology of recurrent miscarriage is a combination of various factors, including chromosomal defects, genetic or structural abnormalities, endocrine abnormalities, infections, immune dysfunction, thrombophilia disorders, antiphospholipid syndrome, and unexplained causes.It has long been known that progesterone is needed to maintain pregnancy and its physiological development. Insufficient progesterone secretion and its low level in the blood serum in early pregnancy is associated with the threat of miscarriage and loss of pregnancy at a later stage – up to 16 weeks of gestation. The effectiveness of the vaginal micronized progesterone (VMP) at a dose of 400 mg twice a day in the first trimester of pregnancy was evaluated in two recent large high-quality multicenter placebo-controlled studies, one of which included pregnant women with recurrent miscarriages of unexplained origin (PROMISE Trial), and the other study included women with early pregnancy loss (PRISM Trial). A key finding, pioneered in the PROMISE study and later confirmed in the PRISM study, was that VMP treatment associated with an increase in live births in line with the number of previous miscarriages. It has been shown that there is no evidence regarding safety concerns with natural micronized progesterone. Treatment with an VMP should be recommended for women with bleeding in early pregnancy and a history of one or more miscarriages. The recommended treatment regimen is 400 mg 2 times a day (800 mg/day) intravaginal, starting from the moment bleeding is detected up to 16 weeks of pregnancy.In the future, there remains uncertainty effectiveness and safety of alternative progestogens (dydrogesterone) for the treatment of women at high risk of threatened abortion and recurrent miscarriage. It is important that dydrogesterone is a synthetic progestin, its structure is significantly different from natural progesterone, and therefore it is necessary to unequivocally prove the short- and long-term safety of this drug before considering its use in clinical practice.

Pregnancy outcome in a bicornuate uterus with bilateral pregnancy presenting as threatened abortion: a case report

Congenital uterine anomalies or mullerian anomalies are prevalent in 0.4 to 10% of women in general and are often manifested by reproductive challenges like miscarriage, premature labor, premature rupture of membranes or malpresentation. Having a bilateral pregnancy in a bicornuate uterus is extremely rare, especially if it is a spontaneous conception.

Experimental substantiation of novocaine therapy for threatened abortion

Published in 1955 by R.A.Vortapetov and P.G.Zhuchenko data on the favorable result of treatment with novocaine in 80 women with threatening termination of pregnancy prompted us to experimentally study the nature of the effect of novocaine introduced into the vascular bed on the intensity of uterine contractions

AN ASSESSMENT INTO THE DIAGNOSTIC VALUE OF ULTRASOUND IN THE FIRST TRIMESTER OF PREGNANCY BLEEDING

Background: One of the most prevalent obstetric issues is vaginal bleeding in the first trimester. It's also one of the most prevalent reasons for emergency admissions, as well as a reason for ultra-sound evaluation in the first trimester. In the first trimester, over a quarter of all pregnant female experience bleeding. Aims and objective: The purpose of this research was to determine the diagnostic value of ultra-sonography in first-trimester haemorrhage. Materials and method: All pregnant female who experienced per vaginal bleeding during the first trimester were included in this research. A semi-structured questionnaire was used to assess all of the selected instances. To arrive at a clinical opinion, a full history and comprehensive clinical evaluation were undertaken, including general, systemic, per abdominal, and per vaginal evaluations. In all of the cases that were chosen, ultra-sonography was used. The results of the clinical evaluation and ultra-sonography were documented. Results: On clinical evaluation, 164 cases of threatened abortion were identified, whereas ultra-sonography verified 102 cases of impending abortion. In 62 cases, there was a discrepancy in opinion. Complete abortion had a 16 percent inconsistancy, while incomplete abortion had a 4 percent inconsistancy. In 20 cases of Blighted ovum, there was a inconsistancy. Out of 214 occurrences of first trimester bleeding, abortion was diagnosed in 200 cases (93.46 percent), ectopic pregnancy in 10 cases (4.67 percent), and hydatiform mole in four cases (1.87 percent). Clinical opinion had a 100% sensitivity in diagnosing a viable intrauterine pregnancy, but only a 44.6 percent specificity. Clinical opinion has a poor statistical correlation in diagnosing nonviable pregnancies, with a sensitivity of 39%. Conclusion: Ultra-sonography has thus been established as a critical diagnostic tool in obstetrics. It is a readily available diagnostic tool that aids in the early detection of problems associated with first-trimester haemorrhage. It was established in the aforementioned research that it had an essential role in the opinion of first trimester haemorrhage. Key Word: first trimester bleeding, ultasonography, diagnostic importance