Recent Advances in Treatment of Recurrent Spontaneous Abortion

Deng, Tianqing; Liao, Xiaoyang; Zhu, Shaomi

doi:10.1097/ogx.0000000000001033

Cited by 45 publications

(32 citation statements)

References 91 publications

(150 reference statements)

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“…Most women with a history of RPL are likely to receive care from tertiary or specialist centers as they will be able to provide them with the care they need to prevent future occurrence. Women with unexplained RPL recognize that no specific cause could be identified in previous diagnostic workups after previous losses ( 31 ).…”

Section: Discussionmentioning

confidence: 99%

Prevalence and associated factors of recurrent pregnancy loss in Nigeria according to different national and international criteria (ASRM/ESHRE vs. WHO/RCOG)

Eleje

Ugwu²,

Igbodike³

et al. 2023

Front. Reprod. Health

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BackgroundIn low-and middle-income countries, no conclusive research explains the prevalence and associated factors of women with a history of recurrent pregnancy loss (RPL). Some authorities have recommended further scientific research on the effect of various definitions of RPL.ObjectiveTo assess prevalence and associated factors of RPL among pregnant women in Nigeria according to different national and international criteria: the American Society for Reproductive Medicine/ European Society for Human Reproduction and Embryology (ASRM/ESHRE; two losses) and the World Health Organization/ Royal College of Obstetricians and Gynecologists (WHO/RCOG; three consecutive losses) criteria.MethodsThis is a cross-sectional analytical study wherein, pregnant women with prior RPL were investigated. The outcome measures were prevalence and risk factors. The associations between independent variables and outcome variable were explored using bivariate and multivariable logistic regression models. The results of these analyses were reported as adjusted odds ratios (AORs) with 95% confidence intervals (95%CI). Factors associated with RPL were identified using multivariate regression models.ResultOf the 378 pregnant women interviewed, the overall prevalence of RPL in this study was found to be 15.34% (95% confidence interval = 11.65%–19.84%). The prevalence of RPL was 15.34% (58/378; 95%CI = 11.65%–19.84%) and 5.29% (20/378; 95%CI = 3.23%–8.17) according to the ASRM and the WHO criterion respectively. Regardless of diagnostic criteria, unexplained (AOR = 23.04; 95%CI: 11.46–36.32), endocrine disturbances (AOR = 9.76; 95%CI: 1.61–63.19), uterine abnormalities (AOR = 13.57; 95%CI: 3.54–50.60), and antiphospholipid syndrome (AOR = 24.59; 95%CI: 8.45–71.04) were positively and independently associated with RPL. No significant risk factors were seen when the ASRM/ ESHRE criterion vs. WHO/RCOG criterion were compared. Advanced maternal age was significantly higher in secondary than in primary type of RPL.ConclusionThe prevalence of RPL was 15.34% and 5.29% according to ASRM/ESHRE and WHO/RCOG criterion respectively, with secondary type predominating. No significant differences with regard to risk factors were seen according to diagnostic criteria studied, though advanced maternal age was significantly higher in secondary RPL. Further research is needed to confirm our findings and to better characterize the magnitude of differences.

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Section: Discussionmentioning

confidence: 99%

Prevalence and associated factors of recurrent pregnancy loss in Nigeria according to different national and international criteria (ASRM/ESHRE vs. WHO/RCOG)

Eleje

Ugwu²,

Igbodike³

et al. 2023

Front. Reprod. Health

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“…Owing to the uncertainty of the pathogenesis, the likelihood of recurrence, recent studies suggest that various treatment of RSA may work (110,111). Clinicians often use progesterone to support or supplement the pregnancy, by oral, vaginal, intramuscular, or other ways.…”

Section: Therapiesmentioning

confidence: 99%

Decidual macrophages in recurrent spontaneous abortion

Zhao

et al. 2022

Front. Immunol.

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Recurrent spontaneous abortion (RSA) is defined as two or more pregnancy loss, affecting the happiness index of fertility couples. The mechanisms involved in the occurrence of RSA are not clear to date. The primary problem for the maternal immune system is how to establish and maintain the immune tolerance to the semi-allogeneic fetuses. During the pregnancy, decidual macrophages mainly play an important role in the immunologic dialogue. The purpose of this study is to explore decidual macrophages, and to understand whether there is a connection between these cells and RSA by analyzing their phenotypes and functions. Pubmed, Web of Science and Embase were searched. The eligibility criterion for this review was evaluating the literature about the pregnancy and macrophages. Any disagreement between the authors was resolved upon discussion and if required by the judgment of the corresponding author. We summarized the latest views on the phenotype, function and dysfunction of decidual macrophages to illuminate its relationship with RSA.

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“…Сьогодні кожна 5-6 жінка втрачає вагітність, при чому переважна кількість самовільних викиднів припадає на І триместр гестації [1,2,3,4]. Результати фундаментальних досліджень, виконаних в останні роки, показали, що формування гестаційних ускладнень закладаються саме в ранні терміни, коли неблагополуччя організму жінки, стан ендоі міометрію обумовлюють неповноцінне формування ембріону, плода та позазародкових структур [ 5,6,7,8].…”

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Characteristics of the Course of the Gestation Period, Childbirth and Newborn Condition in Patients at Threat of Pregnancy Termination in Early Terms

Kravchenko¹,

Solovei²

2022

Neonatol. hìr. perinat. med.

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Despite the successes of modern obstetrics and perinatology, stillbirth occupies one of the leading places inthe structure of perinatal morbidity and mortality. Today, every 5-6 women lose a pregnancy, and the majority of spontaneous miscarriages occur in the 1st trimester of pregnancy.The aim of the study is to examine the peculiarities of the course of the gestation period, childbirth and the condition of newborns in patients with a threat of early termination of pregnancy.Materials and methods. We carried out a retrospective analysis of 100 individual charts of pregnant and parturient women with a threat of abortion in the 1st trimester of pregnancy (the main group). In 40 patients (subgroup I), the threat of termination of pregnancy was accompanied by bleeding, in 60 – the threat of termination without bleeding was diagnosed (subgroup II).The control group consisted of 50 pregnant women with the physiological course of the first trimester of pregnancy. Statisticalanalysis was performed according to generally accepted methods of variational statistics. Reliability was assessed by Student's t-test.Differences were considered significant at a significance level of p≤0.05.The conduct of research was approved by the Ethics Committee of the BSMU, which is confirmed by the protocol of the Commission on Biomedical Ethics regarding the observance of moral and legal rules for conducting medical scientific research.Processing of personal data was carried out after receiving the patient's informed consent.Results and their discussion. The research groups were representative in terms of residence, social status, and education. Menstrual and reproductive anamnesis data in the main and control groups also did not differ significantly. The rate of spontaneous abortions and terminations of pregnancy according to medical indications was significantly higher in women with threatened termination of pregnancy both with and without bleeding compared to controls. Patients of the main group had a significantly higher history of both gynecological diseases and extragenital pathology.Pregnant women with retrochorial hematoma and bleeding accounted for 70%, in 30% of women in the 1st trimester of pregnancy, in the presence of bloody secretions, retrochorial hematoma was not diagnosed. The percentage of asymptomatic retrochorial hematomas was 15%. Anomalous location of the chorion in the 1st trimester of pregnancy was diagnosed much more often in the 1st and 2nd subgroups.The analysis of the further course of pregnancy in women with episodes of miscarriage in the early stages of gestation showed that in the main group the level of perinatal complications, such as the threat of premature birth (30%), placental dysfunction (38%), preeclampsia (11%), fetal distress (20%), SZRP (19%) was significantly higher. Accordingly, the rates of premature birth (13%), fetal distress (25%), and labor anomalies (10%) were higher in childbirth.When analyzing the condition of children at birth, the level of moderate asphyxia in the main group was higher than in the control group (8±2.7% and 0%, respectively). The average weight of full-term newborns in the study group was significantly lower (3020.0±21.4) than that of children in the control group (3685.0±28.1 g) (p<0.05).Conclusions.Pregnant women with a threat of miscarriage in the first trimester of pregnancy are a high-risk group for the occurrence of perinatal complications.The level of complications in the II and III trimesters of pregnancy is significantly higher if the threat of early termination of pregnancy was accompanied by bleeding.In pregnant women with bleeding earlier (up to 8 weeks), compared to patients with bleeding at 9-13 weeks, the frequency of threatened miscarriage in the II trimester of pregnancy, premature birth, placental dysfunction, preeclampsia, and SZRP was significantly higher.

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Recent Advances in Treatment of Recurrent Spontaneous Abortion

Cited by 45 publications

References 91 publications

Prevalence and associated factors of recurrent pregnancy loss in Nigeria according to different national and international criteria (ASRM/ESHRE vs. WHO/RCOG)

Prevalence and associated factors of recurrent pregnancy loss in Nigeria according to different national and international criteria (ASRM/ESHRE vs. WHO/RCOG)

Decidual macrophages in recurrent spontaneous abortion

Characteristics of the Course of the Gestation Period, Childbirth and Newborn Condition in Patients at Threat of Pregnancy Termination in Early Terms

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