Our results suggest that the C/U ratio is a good predictor of neonatal outcome, and could be used to identify fetuses at risk of morbidity and mortality. Fetal umbilical artery AEDV with intrauterine growth restriction is associated with high perinatal morbidity and mortality.

The aims of this study were to determine the aetiological factors and the pattern of recurrent pregnancy loss in Kuwait. Ninety consecutive patients attending the special recurrent miscarriage clinic were studied prospectively. A comprehensive history of all previous miscarriages and pregnancies, past medical and gynaecological events were established. A physical examination was performed. Extensive investigations were performed. Pregnancies which occurred during the study were monitored carefully. The mean age of the patients was 30.46+/-6.04 years. The patients were subdivided into the groups of secondary (57%) and primary (43%) recurrent miscarriages. Eighty-five per cent of all previous miscarriages occurred in the first trimester. The main aetiological factors were uterine anomaly 2.2%, chromosome anomaly (parental) 2.2%, PCOS, infections and other miscellaneous factors 21.1%, positive antiphospholipid antibodies 33.3% and unexplained in 35.6%. The overall live birth rate was 82% and maternal morbidity was low. Positive antiphospholipid antibodies are the most frequently associated cause of recurrent pregnancy loss in Kuwait.

Objective: To investigate the reproductive performance of non-pregnant women with recurrent spontaneous miscarriage (RSM) and the association between RSM and polycystic ovary syndrome (PCOS) in reproductive failure. Subjects and Methods: Fifty non-pregnant women with 3 or more consecutive RSM attending our RSM clinic were evaluated prospectively. Detailed history and physical examination were completed. Extensive laboratory investigations, ultrasonographic, radiological and specialized procedures/tests were performed. Those patients who did not achieve pregnancy within the first 6 months of follow-up had appropriate treatment options implemented. The outcome of any subsequent pregnancies was analyzed. Results: The mean age of the patients was 33.8 ± 4.6 years (range 22–43 years). The aetiological factors associated with RSM were chromosome anomaly, uterine abnormality, antiphospholipid syndrome, PCOS and infections; 40% were ‘unexplained’. Thirty patients (60%) were able to achieve viable pregnancies which progressed to term, resulting in live births. Fourteen of the other 20 patients had high body mass index (BMI) >30 and evidence of PCOS. Of these 20 patients, 13 eventually achieved pregnancies which ended again in first-second-trimester abortions (cause undetermined). The remaining 7 patients (4 with high BMI) who had a combination of male factor/protracted PCOS/ovarian failure did not achieve pregnancies. Conclusion: The association of RSM with PCOS resulted in poor reproductive performance, which may progress to reproductive failure.

The fetal and maternal outcome of pregnancies in patients with primary and secondary recurrent pregnancy loss associated with antiphospholipid syndrome were virtually identical and quite satisfactory. Intravenous immunoglobulin added to the standard therapy resulted in excellent fetal and maternal outcome, although its definitive role will have to wait for the outcome of randomised trials.

Objective: The objective of this study was to explore the role of insulin resistance in women with recurrent spontaneous miscarriage (RSM). Patients with ≧3 consecutive spontaneous miscarriages were classified as having RSM. Subjects and Methods: Thirty-five non-pregnant women presenting with RSM in our specialized RSM clinic constituted the study population, while 30 non-pregnant, parous, fertile women without RSM served as controls. The study and control patients were matched for age, ethnicity and body mass index (BMI). Blood was extracted from these patients for fasting blood glucose and fasting insulin simultaneously, and a battery of investigations including ultrasonography was performed on all the patients with RSM. Results: There was no significant difference in the mean fasting glucose for the study and control patients (5.5 ± 0.7 vs. 5.3 ± 0.6 mmol/dl) and in the mean fasting insulin (15.0 ± 5.1 and 12.9 ± 2.9 mU/l). There was a significant difference between the mean parity of the study and control patients (0.7 ± 0.7 vs. 1.7 ± 0.5, p < 0.0001) and also the mean number of miscarriages (4.2 ± 1.2 vs. 0.1 ± 0.4, p < 0.0001). There was, however, no significant difference in the insulin resistance of both groups as calculated using the Homeostasis Model Assessment and the fasting glucose insulin ratio of <4.5. Conclusion: Insulin resistance was not significantly associated with RSM in our study. Further studies may be needed.