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Habitual Abortion

Recurrent Miscarriage


Presentation

  • In 102 (71%) women, antibiogram-based antibiotic treatment normalized hysteroscopy, histology, and cultures (group 1); while in 40 (28.2%) patients, CE was still present at hysteroscopy (group 2).[ncbi.nlm.nih.gov]
  • Individuals with habitual abortion presented with an abnormal expression of IL-1beta and IL-6 mRNA in endometrium, during the mid-secretory phase.[ncbi.nlm.nih.gov]
  • If you are looking for ASRM Scientific Congress Presenter Guidelines, please go to the Congress Website Presenter Resources[asrm.org]
  • At present a large scale meta-analysis is being performed to confirm or refute the efficacy of this treatment. This meta-analysis may resolve the controversy.[ncbi.nlm.nih.gov]
  • The aim of the present investigation was to estimate the risk of pre-eclampsia in women with recurrent miscarriage and infertility. Cohort study. The Norwegian Mother and Child Cohort Study (MoBa), a large population-based pregnancy cohort.[ncbi.nlm.nih.gov]
Withdrawn
  • Women were withdrawn from the trial if they had not become pregnant within 2 years after randomization or if they no longer wished to become pregnant; however, these women were included in the intention-to-treat analysis.[doi.org]

Workup

  • The authors also conclude, "that hysteroscopy should be a part of the diagnostic workup of infertile women complaining of unexplained recurrent miscarriage."[en.wikipedia.org]
  • Most patients with a history of recurrent miscarriage do not benefit from an extensive infection workup. For related information, see the following Medscape Reference articles.[emedicine.medscape.com]
  • It is of utmost importance that the laboratory has its interest invested in infertility workups.[fertilitysolution.com]

Treatment

  • Antibiotic treatment seems to be associated with an improved reproductive outcome.[ncbi.nlm.nih.gov]
  • Like treatment timing and duration, there was great heterogeneity in the mode of treatment administration. The majority of trials administered intervention intravenously, although some also administered treatment intramuscularly and subcutaneously.[doi.org]
  • Women without thrombophilia were given explanations regarding the types of treatment available and the research statistics to assist them in reaching an informed decision whether to choose treatment with enoxaparin or aspirin.[doi.org]
  • One study found that in many women with chronic endometritis, "fertility was restored after appropriate antibiotic treatment."There are currently no treatments for women with unexplained recurrent pregnancy loss.[en.wikipedia.org]
  • The treatment resulted in varying degrees of improvement in blood rheology and the level of serum (human) chorionic gonadotropin (HCG).[ncbi.nlm.nih.gov]

Prognosis

  • Management – Unexplained RM  Good prognosis for future pregnancy outcome  75% chance of a eventual live birth in subsequent pregnancy  However, prognosis worsens with:  Increasing maternal age  Number of previous miscarriages  Maternal age and number[slideshare.net]
  • . * Disease is ‘‘any deviation from or interruption of the normal structure or function of any part, organ, or system of the body as manifested by characteristic symptoms and signs; the etiology, pathology, and prognosis may be known or unknown.’’[web.archive.org]
  • The definition of recurrent miscarriage must be made on the basis of prognosis for future pregnancies, and patients who have had two or more miscarriages probably should be evaluated.[nccrm.com]
  • In all patients, genetic variants associated with low plasma mannose binding lectin or thrombophilia affect the prognosis negatively.[forskning.ku.dk]
  • Pregnancy prognosis following repeated abortion. Am J Obstet Gynecol 1954; 68: 665–673. PubMed Google Scholar 19. Shearman RP, Garrett WJ. Double-blind study of the effect of 17-hydroxyprogesterone caproate on abortion rate.[link.springer.com]

Etiology

  • If patients are evaluated with an etiology in mind, a comprehensive study and management can be planned that will save time and expense.[ncbi.nlm.nih.gov]
  • Abstract Forty-nine women who suffered recurrent spontaneous abortion of unknown etiology were studied for cellular reactivity and blocking antibody in one-way mixed lymphocyte culture before and after their receipt of three transfusions of leukocyte-rich[ncbi.nlm.nih.gov]
  • We discuss the possible mechanisms and etiological importance of this finding in habitual abortion.[ncbi.nlm.nih.gov]
  • Abstract Three hundred and thirty-seven women with habitual abortion of unknown etiology were studied for cellular reactivity and blocking antibody in one-way mixed lymphocyte culture.[ncbi.nlm.nih.gov]
  • . * Disease is ‘‘any deviation from or interruption of the normal structure or function of any part, organ, or system of the body as manifested by characteristic symptoms and signs; the etiology, pathology, and prognosis may be known or unknown.’’[web.archive.org]

Epidemiology

  • Epidemiological, immunogenetic and immunological studies support the hypothesis that aberrant maternal H-Y immune responses have a pathogenic role in SRM.[ncbi.nlm.nih.gov]
  • Regarding epidemiology it should be noted that the incidence of clinical abortion in the general population is 12-15%.[creafampuebla.com]
  • Epidemiology varies depending on the age of the mother . A mother under age 30, has only 25% chances to have another abortion. On the other hand, being older than 40 increases the rate up to 50-60%.[invitra.com]
  • Werler, Induced Abortions and the Risk of Preeclampsia Among Nulliparous Women, American Journal of Epidemiology, 182, 8, (663), (2015).[doi.org]
  • A study of epidemiology and fetal effects of human parvovirus B19 surg Gynecol Obstet. 1988;163(3):243-50. cohen BJ. Dtection of parvovirus B19 specific IgM by antibody capture radio immunosassay. Journal virol Metods. 1997;66(1):1-4. Djuki s.[jri.ir]
Sex distribution
Age distribution

Pathophysiology

  • If the vascular hypothesis for the pathophysiology of miscarriage is accepted ( Hustin and Jauniaux 1997 ), bed rest may improve pressure variation and flow changes, and therefore improve the outcome.[clinicalgate.com]
  • Implications for research Effective treatment of an alleged alloimmune cause of recurrent miscarriage awaits more complete knowledge of the underlying pathophysiology.[doi.org]
  • Recurrent miscarriage: Pathophysiology and outcome. Curr Opin Obstet Gynecol 2005;17:591-7. 105. Glueck CJ, Streicher P, Wang P. Treatment of polycystic ovary syndrome with insulin-lowering agents. Expert Opin Pharmacother 2002;3:1177-89. 106.[doi.org]
  • None of the women with thyroid autoantibodies had clinically evident thyroid disease, and the increase in pregnancy loss was not due to changes in thyroid hormone levels or APLA. [10] The pathophysiology involved in this phenomenon is unclear and probably[emedicine.medscape.com]
  • They stated that further studies are needed to elucidate the roles of anti-HSP antibodies and their pathophysiology in unexplained RPL.[aetna.com]

Prevention

  • How else can a woman try to prevent recurrent pregnancy loss? Q. What is a miscarriage? A. A miscarriage is a pregnancy loss before five months gestation. Back to Top Q. How common is miscarriage? A.[web.archive.org]
  • Abstract In order to investigate the possible role of suppressor cells in paternal leukocyte immunization to prevent recurrent miscarriages, peripheral blood lymphocytes from habitually aborting women before and after immunization were assessed.[ncbi.nlm.nih.gov]
  • Immunization by paternal leukocytes has been used to potentiate the immune response and prevent further miscarriages. This treatment has been highly controversial in terms of efficacy, mode of action, and side effects.[ncbi.nlm.nih.gov]
  • Progestogen for preventing miscarriage. Cochrane Database Syst Rev 2008;2:CD003511. 102. Oates-Whitehead RM, Haas DM, Carrier JA. Progestogen for preventing miscarriage. Cochrane Database Syst Rev 2003;4:CD003511. 103. Daya S.[doi.org]
  • Th2 cytokines are thought to benefit the developing embryo by enhancing placental growth and function, and possibly by preventing inappropriate apoptosis.[ncbi.nlm.nih.gov]

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