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Miscarriages (Habitual and Unexplained Losses)
Published in Charles Theisler, Adjuvant Medical Care, 2023
A miscarriage is the loss of a fetus before the twentieth week of pregnancy. The etiology of recurrent spontaneous abortions in otherwise healthy women remains unknown in about half of all cases. Recurrent pregnancy loss is defined as the loss (miscarriage) of three or more consecutive pregnancies. According to the March of Dimes, as many as 50% of all pregnancies and almost 20% of all recognized pregnancies end in miscarriage.
DRCOG MCQs for Circuit C Answers
Published in Una F. Coales, DRCOG: Practice MCQs and OSCEs: How to Pass First Time three Complete MCQ Practice Exams (180 MCQs) Three Complete OSCE Practice Papers (60 Questions) Detailed Answers and Tips, 2020
Investigations for recurrent miscarriages (RM) include full blood count, serum FSH and LH levels in the mother, chromosomal karyotyping of both parents, screening for antiphospholipid antibodies, anticardiolipin and lupus anticoagulant, high vaginal and endocervical swabs, and transvaginal ultrasound (to exclude anatomical anomaly). A hysterosalpingogram and hysteroscopy may also be indicated if the ultrasound is suggestive. Parental chromosome abnormality is found in 3-5% of couples. Antiphospholipid antibodies are found in 15% of women. Bacterial vaginosis and cervical incompetence are two causes of second trimester miscarriages.
Infertility to Motherhood
Published in Nora Swan-Foster, Art Therapy and Childbearing Issues, 2020
I experienced an inferred message within the power differential of care that conveyed to me that if I follow the doctor’s orders then I will be able to carry the baby to term. During these first critical weeks, my body was going through tremendous changes; my hormones were shifting and I was gaining weight and was expected to hide it. One of the miscarriages required me to have a dilation and curettage (D&C) procedure. I was emotionally devastated and received a medicalized detached response from the practitioner with an expectation that sending me home with a pamphlet was sufficient, and I could return to work after a few days.
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].
Effect of orlistat intervention on in vitro fertilization/intracytoplasmic sperm injection outcome in overweight/obese infertile women
Published in Gynecological Endocrinology, 2022
Jing Tong, Lulu Xiang, Yichao Niu, Ting Zhang
The pregnancy outcomes were defined according to ‘International Committee for Monitoring Assisted Reproductive Technology (ICMART) and the World Health Organization (WHO) Revised Glossary of ART Terminology, 2009’ [11]. Pregnancy tests were conducted at 2 weeks after embryo transfer. Biochemical pregnancy (preclinical spontaneous abortion/miscarriage) was defined as a pregnancy diagnosed only by the detection of hCG in serum or urine and that does not develop in clinical pregnancy. Clinical pregnancy was defined as a pregnancy diagnosed by ultrasonographic visualization of one or more gestational sacs or definitive clinical signs of pregnancy. It included ectopic pregnancy. Clinical pregnancy rate was defined the number of clinical pregnancies expressed per 100 embryo transfer cycles. Miscarriage was defined as pregnancy loss before 20 weeks of gestation. Live birth was defined as the complete expulsion or extraction from its mother of a product of fertilization, irrespective of the duration of the pregnancy, which, after such separation, breathes or shows any other evidence of life, such as heart beat, umbilical cord pulsation, or definite movement of voluntary muscles, irrespective of whether the umbilical cord has been cut or the placenta is attached. Live birth rate was defined the number of live births expressed per 100 embryo transfer cycles.
Monitoring of hemostatic parameters for early prediction of first-trimester miscarriage
Published in Biomarkers, 2021
Limei Jiang, Yingjian Du, Yi Lu, Xuelian Wu, Xuedong Tong
About 15–25% miscarriages occurred during the first 13 weeks of pregnancy and were defined as first-trimester miscarriage or early pregnancy loss (Luise 2002, Jurkovic et al. 2013, Schreiber et al. 2018). First-trimester miscarriage is gradually becoming a major public health issue with many women now choose to delay childbearing (Rai et al. 2006). Abnormal vaginal bleeding or abdominal pain are common complications of miscarriage affects 16–25% of all pregnancies (Vejborg et al. 2007, Preisler et al. 2015). Clinical confirmation of these early pregnancy-related symptoms or signs requires biochemical (serum active β-subunit of serum human chorionic gonadotropin (hCG) and/or progesterone) and ultrasound evaluation (Thorstensen, 2000). Several other laboratory parameters including lymphocyte subpopulations, neutrophil lymphocyte ratio (NLR), systemic immune inflammation index, are also well established for miscarriage due to progress in the fields of cytogenetics and immunogenetics in recent years (Dimitriadis et al. 2020, Tanacan et al. 2020). However, the association between maternal coagulation abnormalities and first-trimester miscarriage still not fully explained. Asymptomatic patients might benefit from laboratory examinations of coagulation other than ultrasound or the above indicators.