A prospective study of 63 couples with a history of recurrent spontaneous abortion: contributing factors and outcome of subsequent pregnancies

Abstract

To evaluate the possible causes of recurrent spontaneous abortion (RSA) and to elucidate the prognosis for subsequent pregnancies 63 RSA patients were studied. Parental karyotyping revealed chromosomal aberrations in six of the 63 couples (4.8%). The rate of increased concentrations of antibodies against cardiolipin was comparable in the patients (10.0%) and in 30 parous controls (6.7%), as was also the occurrence of other autoantibodies (43.3 and 36.7%, respectively). Hysteroscopy revealed uterine cavity abnormalities in 11 of the 55 patients studied (20.0%). Altogether, for 35 RSA women (55.4%) investigations resulted in entirely normal findings; abnormal findings were more frequently encountered in primary aborters (56.8%) than in secondary aborters (26.9%, P < 0.05). During the follow-up period of 24.1 +/- 15.4 months, 48 patients became pregnant a total of 65 times, and the cumulative live birth rate was 62.5%. A living fetus was seen in ultrasound examination in 46 pregnancies (70.7%), whereas a blighted ovum was diagnosed in nine pregnancies (13.8%). An additional nine pregnancies aborted so suddenly that no ultrasound examination was performed, and one ectopic pregnancy was treated laparoscopically. Of the initially viable pregnancies, 13 (28.3%) ended in miscarriage and two were terminated due to fetal anomalies. Normal findings in the investigations were associated with a smaller risk for abortion (40.0%) than were abnormal findings (65.5%, P < 0.05). Of the 30 babies, six (20.0%, with babies from one twin pregnancy excluded) were growth-retarded, 9.7% were born before 37 weeks of gestation, and 22.8% of the mothers had impaired glucose tolerance during pregnancy.(ABSTRACT TRUNCATED AT 250 WORDS)

Study of Thrombophilia in Recurrent Pregnancy Loss

“…The incidence of pregnancy complications like spontaneous abortion, preterm birth, and intrauterine growth retardation were found in 16.67, 13.33, and 26.67 % of pregnancies, respectively. Similar observation was found in the series published by Tulppala et al [20] who conducted a prospective study of 32 deliveries in 63 women with RPL and found that pregnancy complications like preterm delivery and IUGR were 9.7 and 20 %, respectively, in these women.…”

Identification of Quantitative Trait Loci responsible for embryonic lethality in mice assessed by ultrasonography

“…The diverse aetiologies associated with RSA, include chromosomal alterations (Stephenson et al, 2002), maternal and foetal structural abnormalities (Philipp et al, 2003, Salim et al, 2003, thrombophilic disorders (Rey et al, 2003) and autoimmune disorders such as the antiphospholipid syndrome (Levine et al, 2002). Nevertheless, in ~50 % of the cases the aetiology remains unknown (Li et al, 2002, Plouffe et al, 1992Tulppala et al, 1993), indicating that the underlying aetiological grounds constitute a complex lattice of genetic and environmental causes. Previous attempts to describe genetic factors using the candidate gene approach have been relatively unsuccessful (Kaare et al, 2006, Kaare et al, 2007.…”

Association of recurrent pregnancy loss and anticardiolipin antibodies: prevalence and prognosis of subsequent pregnancy in women with recurrent pregnancy loss

“…In the previous prospective studies, the effect of ACA on live birth rate has been reported comparable to our researcher, which has a negative impact on live birth. 24,14,17 The limitations of the present study are its smaller sample size and single centre study; however, our study does not differ from previously reported studies on this topic.…”

“…7,[9][10][11][12][13][15][16][17] In the prospective studies, the effect of ACA on live birth rate has been reported very differently, The different results in the prospective studies could partly be attributed to poorly standardized ACA tests reflected in a significant interlaboratory variation in the detection of ACA significant fluctuations of the antibody levels over time in the same patient and very different cut off levels. [17][18][19][20][21][22][23][24] For an obstetrician who is treating patients with recurrent pregnancy loss, previous studies do not adequately answer the question: what are the prognostic value of an elevated ACA titre and the development of late pregnancy complications such as preeclampsia, low birth weight and preterm labour? Therefore, present study objective was to compare the prevalence of ACA in patients with recurrent pregnancy loss and normal healthy pregnant women and its association of complication and obstetric outcomes.…”