Preventing recurrent miscarriage of unknown aetiology

Miscarriage is defined as an adverse and unexpected termination of pregnancy before the completion of 22 nd week of gestation. Currently, abortion is the most common early reproductive failure. In Poland, more than 40 000 pregnant women a year lose pregnancy due to various reasons. There are many reports in literature on the risk of somatic consequences of miscarriage, while extra-somatic complications resulting from exposure to the strong influence of anxiety and stress, such as, for example: depression and psychosomatic disorders have not been paid too much attention to, yet. Abortion is accompanied by stress and a lot of negative emotions, such as anxiety. They may intensify both due to hospitalization and the need to implement treatment. These negative emotions destroy cognitive power of women, depriving them of their confidence, they can exacerbate the sense of danger, lead to stress and hinder treatment.

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“…In clinical practice, e.g. in case of trauma associated with miscarriage, anxiety can disaptative and harmful effect to health [22][23][24].…”

Section: Anxiety and Miscarriagementioning

confidence: 99%

Anxiety and stress in miscarriage

Kicia

Skurzak

Wiktor

et al. 2015

Polish Journal of Public Health

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“…Congenital uterine anomalies are found in 1.8% to 37.6% of women with RPL (Rai et al, 2006;Ford et al, 2009;Morley et al, 2013). Intrauterine septum is the most common congenital anomaly, and that which is most closely linked to RPL.…”

Section: Reproductive Tract Malformationmentioning

confidence: 99%

Platelet aggregation in healthy women during normal pregnancy - a longitudinal study

et al. 2018

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Increased platelet activation is involved in obstetric complications such as preeclampsia and intrauterine growth retardation. It is of interest to study platelet aggregation during pregnancy, since increased aggregation theoretically could be a mechanism associated with placenta-mediated complications, which possibly could be prevented by drugs inhibiting platelet aggregation. There are, however, few robust studies describing platelet aggregation during normal pregnancy. The present longitudinal study was performed in order to study platelet aggregation during normal pregnancy resulting in a healthy child, during the puerperium and in nonpregnant, fertile women. Healthy, nonsmoking, pregnant women (n = 104), aged under 39 years and with BMI < 35, were followed during pregnancy and postpartum. Twenty-seven nonpregnant, non-puerperal, fertile women were studied for comparison. Platelet aggregation was determined with multiple electrode impedance aggregometry and analyzed at inclusion, 4 times during pregnancy and after at least 3 months postpartum. Platelet aggregation postpartum was compared with gestational weeks 8-15 and 37-40, respectively, and with nonpregnant, fertile women. Hemoglobin, leucocyte count, platelet count, prothrombin time, and activated partial thromboplastin time were determined at inclusion in order to verify normal hemostasis. Activation of platelets by arachidonic acid, adenosine diphosphate (ADP), and thrombin receptor activating peptide (trap-6) resulted in less aggregation during pregnancy, compared with postpartum (p < 0.03-< 0.001). Platelet aggregation following activation by collagen was unchanged. A minor increase in aggregation as pregnancy continued was found related to ADP (p < 0.021). Positive correlations were found between platelet counts and platelet aggregation. Postpartum platelet aggregation after activation with arachidonic acid, collagen, and trap-6 was lower than in the non-puerperal fertile state. Other hemostatic analyses were normal. In conclusion, there is a minor decrease in platelet aggregation after activation with arachidonic acid, trap-6, and ADP, measured with multiple electrode impedance aggregometry during normal pregnancy resulting in healthy babies, compared with the postpartum period. The small changes in platelet aggregation may be a consequence of a minor decrease in platelet count and probably lack clinical significance under normal conditions. Interindividual variations at certain time-points are substantial, which limits the usefulness of the multiple electrode impedance aggregometry for determining minor changes in platelet function.

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“…Women who have reproductive problems secondary to congenital uterine anomalies may struggle with the psychological and emotional repercussions of having a congenital anomaly, as well as recurrent pregnancy loss . Both women and their partners suffer from increased stress, guilt, and depression following pregnancy loss, and increased anxiety regarding future pregnancies . Moore et al recommend evaluating these women for complicated grief, providing information and support about their medical condition and the grieving process, and referring for counseling as needed .…”

Section: Diagnosis and Managementmentioning

confidence: 99%

Congenital Uterine Anomalies and Uterine Rupture

Lovelace¹

2016

J Midwife Womens Health

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Congenital uterine anomalies are more common than previously recognized. While many women will have no symptoms or problems, some women with congenital uterine anomalies have increased risks of adverse outcomes during pregnancy. This article presents a case study of a woman with a congenital uterine anomaly leading to spontaneous rupture of her unscarred uterus remote from term. The most common types of congenital uterine anomalies and their associated reproductive risks are reviewed. Evaluation of congenital uterine anomalies and management alternatives are discussed.

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Preventing recurrent miscarriage of unknown aetiology

Cited by 12 publications

References 55 publications

Anxiety and stress in miscarriage

Anxiety and stress in miscarriage

Platelet aggregation in healthy women during normal pregnancy - a longitudinal study

Congenital Uterine Anomalies and Uterine Rupture

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