The purpose is to find abnormalities in the parents that could be passed on to the offspring or that may result in miscarriage.

Emobileclinic Trending Topic: Miscarriage

It is the most common complication of pregnancy; it is the spontaneous loss of a pregnancy before the fetus has reached viability. Recurrent pregnancy loss is classically defined as the occurrence of three or more consecutive pregnancy loss; however, the American Society of Reproductive Medicine (ASRM) has recently redefined recurrent pregnancy loss as two or more pregnancy losses. A pregnancy loss is defined as a clinically-recognized pregnancy involuntarily ending before 20 weeks. A clinically-recognized pregnancy means that the pregnancy has been visualized on an ultrasound or that pregnancy tissue was identified after a pregnancy loss.

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The term therefore includes all pregnancy losses from the time of conception until 24 weeks of gestation in the UK, but may be 20 weeks of gestation in other parts of the world. Miscarriage occurs in 15-20% of recognised pregnancies. 1% of couples trying to conceive have recurrent miscarriages. Following three consecutive miscarriages, the risk of further miscarriage is about 40%. A woman may develop recurrent miscarriage after a successful pregnancy. No underlying cause is found in many of them.
Signs of a Miscarriage.

In early pregnancy, spotting is normal, but if you experience menstrual-like cramps or severe abdominal pain and bleeding, you may be experiencing a miscarriage and should call your health care provider. She may decide to do an exam to check your cervix; if it is dilated, a miscarriage is likely. If you have had an early miscarriage, chances are you won’t require any medical treatment, but in some cases you’ll need a procedure called a dilation and curettage (D&C) to remove the embryonic tissue.

Risk factors

Antiphospholipid syndrome
Uterine anomalies (arcuate or septate)
Cervical incompetence.
Polycystic ovarian syndrome
Uncontrolled diabetes mellitus
Inherited thrombophilia such as protein C and S deficiency
Bacterial vaginosis
Chromosomal disorders
Reduced ovarian reserve
Lifestyle factors like smoking and high consumption of alcohol

Management

Reassurance should be given about the high probability of a successful outcome.
Heparin combined with low-dose aspirin improves live birth rate to 70%.
Use of metformin during pregnancy is associated with a reduction in the miscarriage rate in women with polycystic ovarian syndrome.
Cervical cerclage (a Shirodkar or McDonald suture) is used where cervical incompetence is suspected.

Recurrent Pregnancy Loss Testing?

Karyotype analysis: it is the chromosomal, or genetic, make-up of a person. The purpose is to find abnormalities in the parents that could be passed on to the offspring or that may result in miscarriage.
The uterine evaluation including a/an ultrasound, saline ultrasound, hysterosalpingogram X-ray, MRI (magnetic resonance imaging), and/or hysteroscopy
Hormone profile
Ovarian reserve

 



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