China
Africa
Explore chapters and articles related to this topic
Analgesics during Pregnancy
Published in “Bert” Bertis Britt Little, Drugs and Pregnancy, 2022
The ACOG recommendations (ACOG Committee Opinion, 2018a) for Low-Dose Aspirin (81 mg/day) Use in Pregnancy are: Recommended for women at high risk of preeclampsia; therapy should be initiated 12 to 28 weeks of gestation and continued until delivery.Should be considered for women with moderate risks for preeclampsia.Not recommended for unexplained stillbirth in the absence of risk for preeclampsia.Not recommended for prevention of fetal growth restriction.Not recommended for prevention of preterm birth in the absence of risk for preeclampsia.Not recommended for prevention of early pregnancy loss.
Early Pregnancy Loss
Published in Vincenzo Berghella, Obstetric Evidence Based Guidelines, 2022
Lisa K. Perriera, Beatrice A. Chen, Aileen M. Gariepy
Early PL: Inclusive medical term describing inevitable abortion, incomplete abortion, anembryonic pregnancy, and embryonic/fetal demise at <14 weeks [1]. It is also called “first-trimester” PL. Early first-trimester PL is a loss of pregnancy between conception and 96/7 weeks. Late first-trimester PL is a loss of pregnancy between 10 and 136/7 weeks. The terms early pregnancy loss, miscarriage, and spontaneous abortion are often used interchangeably in the first trimester [2].
Products of Conception
Published in Carlos Simón, Carmen Rubio, Handbook of Genetic Diagnostic Technologies in Reproductive Medicine, 2022
Nasser Al-Asmar, Marcia Riboldi
The primary cause of early pregnancy loss is the presence of a chromosomal abnormality that is incompatible with life. Chromosomal abnormalities are present in up to 50% of first-trimester losses (2) and the causes of the remaining 50% of miscarriages and perinatal loss are heterogeneous. One-quarter to one-half of all miscarriages reported are of unexplained origin. Established causes of pregnancy loss include parental or de novo chromosomal aberrations (2), antiphospholipid syndrome (3), inherited thrombophilia, such as factor V Leiden and prothrombin G20210A gene mutations (4,5), congenital or acquired uterine anomalies (6), endocrine, autoimmune, or alloimmune disturbances (7), as well as the consequences of lifestyle habits (e.g., smoking, obesity, or psychological stress) (8,9). Once uterine malformations, endocrine pathologies, and antiphospholipid syndrome are ruled out, parental karyotype assessment should be considered, especially if the miscarriages were karyotypically abnormal (10).
Histological Evaluation of Products of Conception, Who Benefits from It?
Published in Fetal and Pediatric Pathology, 2023
Haleh Soltanghoraee, Arash Mohazzab, Azadeh Soltani, Soheila Ansaripour, Maryam Tavakoli, Maryam Rafati, Amir Hassan Zarnani, Saeed Reza Ghaffari
There are several main etiologies for early pregnancy loss; some of which bring about sufficient morphological clues for a definitive diagnosis. The primary causes of early miscarriages are genetic defects, especially numerical chromosomal abnormalities and molar pregnancies, followed by other factors such as infectious causes, immunological issues, implantation abnormalities, uterine anatomical defects and endocrine abnormalities [7]. A significant number of miscarriages still remain unexplained despite all investigations. The main causes of recurrent pregnancy losses are almost the same, although they differ in distribution and details [8]. Genetic evaluation of tissue specimens from miscarriages shows chromosomal abnormalities in 45% of sporadic cases, and slightly less in recurrent miscarriages (39%) [9]. Among them, trisomies (mostly involving chromosomes 16, 21, and 22) are the leading abnormalities which are especially prevalent in older maternal age [10]. Chromosomal evaluation of products of conception is recommended by some recurrent miscarriage guidelines such as ESHRE, RCOG, and ASRM [11–13].
Is low anti-Mullerian hormone (AMH) level a risk factor of miscarriage in women <37 years old undergoing in vitro fertilization (IVF)?
Published in Human Fertility, 2022
Anne-Sophie Cornille, Clémence Sapet, Arnaud Reignier, Florence Leperlier, Paul Barrière, Pascal Caillet, Thomas Fréour, Tiphaine Lefebvre
Early pregnancy loss (spontaneous expulsion of an intra uterine pregnancy of less than 12 weeks), complicate 10–25% of clinical pregnancies (Neilson et al., 2010), both spontaneous and after assisted reproductive technology (ART). The association of maternal age with increased risk of miscarriage (Nybo Andersen et al., 2000), has been largely demonstrated to be caused by embryonic aneuploidy, mainly originating from an increased prevalence of meiotic errors during oogenesis and reflecting an alteration of oocyte quality with age (Spandorfer et al., 2004). However, in young women with DOR, it remains controversial whether the quantitative alteration of ovarian reserve is associated with a qualitative alteration of oocyte quality, which could ultimately lead to increased risk of miscarriage.
Live birth rate following undisturbed embryo culture at low oxygen in a time-lapse incubator compared to a high-quality benchtop incubator
Published in Human Fertility, 2022
Dimitrios Kalleas, Keith McEvoy, Gregory Horne, Stephen A. Roberts, Daniel R. Brison
In contrast to the conclusions of previous studies (Barberet et al., 2018; Cruz et al., 2011; Kahraman, Cetinkaya, Pirkevi, Yelke, & Kumtepe, 2012; Kirkegaard, Hindkjaer, Grøndahl, Kesmodel, & Ingerslev, 2012; Nakahara et al., 2010; Park, Bergh, Selleskog, Thurin-Kjellberg, & Lundin, 2015), our data suggest that a less disturbed embryo culture environment in the EmbryoScope system is beneficial, even in comparison to a high-quality K-systems benchtop control incubator using optimized conditions including 5% O2. We see a higher live birth rate with EmbryoScope, regardless of day of transfer or use of IVF/ICSI cycles. This effect appears to act via reducing early pregnancy loss. Somewhat counter-intuitively however, EmbryoScope culture generates embryos which are assessed as having slightly higher cell number, but slightly lower morphological grade.