Recurrent Miscarriage Clinics

Berg, Merel M.J. van den; Vissenberg, Rosa; Goddijn, Mariëtte

doi:10.1016/j.ogc.2013.10.010

Cited by 29 publications

(21 citation statements)

References 33 publications

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“…It occurs in 2-4% of reproduc-tive-aged women, of which 40-55% cases remain unexplained (Li et al, 2002;Van den Berg et al, 2014). RSA is one of the most common complications associated with early pregnancy and remains a challenge in gynecology (Jauniaux et al, 2006).…”

Section: Introductionmentioning

confidence: 99%

Genetic association between the HLA-G 14-bp insertion/deletion polymorphism and the recurrent spontaneous abortions in Saudi Arabian women

et al. 2015

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ABSTRACT. The non-classical class I human leukocyte antigen (HLA)-G molecule was found to be predominately expressed in the extravillous cytotrophoblasts at the fetal-maternal interface during pregnancy. This molecule is critically important for successful implantation during human pregnancy. The polymorphic insertiondeletion (indel) 14-base pair (bp) site localized at the 3' untranslated region was associated with HLA-G mRNA stability and isoform alternative splicing patterns, and thus may influence HLA-G function during pregnancy. We studied the association between the 14-bp indel polymorphism (rs16375) at the 3' untranslated region with recurrent spontaneous abortions in a Saudi population living in Riyadh. A group HLA-G 14-bp polymorphism and recurrent spontaneous abortion of 64 women with 2-11 successive abortions were included in this study. The control group included 62 women without reported abortions and at least 2 pregnancies, all visiting the King Khaled Hospital in Riyadh. The 14-bp indel was genotyped in the case and control groups. The frequency of the genotype +14/+14 was slightly higher in women with recurrent spontaneous abortions, but no significant differences were observed in the distribution of alleles and genotypes.

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Section: Introductionmentioning

confidence: 99%

Genetic association between the HLA-G 14-bp insertion/deletion polymorphism and the recurrent spontaneous abortions in Saudi Arabian women

et al. 2015

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“…Um outro estudo 21 , que teve como objetivo verificar a associação entre IMC e gestação futura em 696 mulheres com perdas gestacionais de causas desconhecidas, revelou a obesidade como fator de risco independente para outro abortamento, acrescido pela idade materna e quantidade de abortos prévios. No presente material, aproximadamente um terço das mulheres com perdas está no grupo sobrepeso/ obesa, embora aquelas realmente obesas representem uma pequena proporção que, de acordo com a recomendação destes autores e outros serviços 17 , necessitam de ajuste ponderal na fase pré-concepcional, com alimentação adequada e exercícios físicos regulares para um aumento da chance do êxito gestacional.…”

Section: Discussionunclassified

“…Tão instigante constatação dá ensejo a investigações no sítio da implantação embrionária, como a expressão de proteínas relacionadas à receptividade do tecido endometrial 9 , e muitas outras envolvendo cromossomos 10,11 e polimorfismos em genes relacionados às trombofilias hereditárias [12][13][14][15] . Por outro lado, considerando a obesidade como um problema de saúde pública na atualidade e a gestação como um dos fatores clássicos de desencadeamento e manutenção dessa condição 16,17 , estudos têm relatado efeitos adversos na evolução e nos resultados gestacionais, destacando-se maior risco para pré-eclâmpsia e macrossomia [18][19][20] . Em relação às mulheres com perdas gestacionais, está evidenciado 21 o aumento do risco de aborto em gestação subsequente nas obesas.…”

Section: Introductionunclassified

“…A dificuldade na interpretação e na comparação dos resultados leva os obstetras a indicarem a utilização de terapêuticas, por vezes sem eficácia comprovada, movidos pela ansiedade das próprias mulheres 17 . Em contrapartida, o conhecimento de que as perdas sucessivas tendem a ocorrer na mesma idade gestacional das precedentes 7 , conquanto represente a época de maior temor para as pacientes, permite a tomada de providências favoráveis ao êxito reprodutivo.…”

Section: Introductionunclassified

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Aspectos epidemiológicos e obstétricos de mulheres com perdas recorrentes da gravidez em uma maternidade pública do Nordeste do Brasil

Costa

Santos

Netto

2014

Rev. Bras. Ginecol. Obstet.

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. RESULTADOS: A média de idade das mulheres de perdas foi mais elevada do que no Controle (32,3±6,3 versus 26,5±6,4 anos; p<0,01). Houve predomínio do consumo de bebidas alcoólicas no grupo de perdas (36,9 versus 22,1%; p=0,01), assim como no estado civil (93,2 versus 66,7%; p<0,01), no qual elas eram casadas ou viviam em união estável, respectivamente. O índice de massa corpórea pré-gestacional foi superior no grupo de perdas (26,9 versus 23,5%; p<0,01). Nos antecedentes obstétricos, 103 mulheres com perdas gestacionais relataram 334 gestações. Destas, 56 tiveram dois ou mais abortos no primeiro trimestre e em 31 delas, duas ou mais gestações evoluíram para abortos tardios/prematuros extremos. CONCLUSÕES: Mulheres com perdas recorrentes incluídas neste estudo tiveram alguns fatores de risco identificados, tais como a idade mais avançada e o índice de massa corpórea superior. As observações são coerentes com as propostas mais recentes a respeito de perdas recorrentes que consideram a inclusão das perdas em várias idades gestacionais.Abstract PURPOSE: To describe the epidemiologic and obstetric characteristics of women with recurrent miscarriages. METHODS: A descriptive and analytical study whose inclusion criterion was every woman that was attended at the clinic for recurrent miscarriage (loss group), between January 2006 and December 2010. Patients that did not live in Salvador, Bahia, Brazil, and those who were not reached by telephone or whose number was not included in the medical record were not included. The Control Group consisted of 204 pregnant women seen at the low-risk prenatal care unit between May 2007 and April 2008. Women who did not accept to be interviewed and those with obstetric risk were excluded from the Control Group. The analyzed variables were: age, education, occupation, marital status, alcohol consumption, body mass index, obstetric history and the gestational age when the losses occurred. The SPSS 18.0 program was used for statistical analysis. Means and standard deviations of continuous variables were compared using the Student's t-test and the frequencies of the nominal variables were compared by the χ 2 test. RESULTS: The mean age of women in the loss group was higher than in the Control Group (32.3±6.3 versus 26.5±6.4 years old, p<0.01).

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“…Recurrent miscarriage and preterm delivery are highly prevalent entities in Obstetrics (39,40,41), which result in tremendous social and economic burdens (77,78). At present, much effort is being invested in order to reduce their impact on families and health services.…”

Section: In Favour Of Treating Subclinical Thyroid Dysfunctionmentioning

confidence: 99%

Identifying and treating subclinical thyroid dysfunction in pregnancy: emerging controversies

Velasco

Taylor

2018

European Journal of Endocrinology

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Thyroid hormones are essential for an adequate growth and development of the fetus. In addition to the classical association between maternal hypothyroidism and neurological impairment in the progeny, other adverse reproductive events have been associated with maternal thyroid dysfunction including infertility, miscarriage and preterm delivery. Although all scientific societies endorse the treatment of overt hypothyroidism; the management and/or treatment of subclinical hypothyroidism, hypothyroxinemia or antithyroid antibody-positive women should be considered with caution. Important trials have found no clear benefit of treatment of subclinical hypothyroidism in terms of cognitive outcomes; however, other interventional studies appear to reduce some of the obstetric and perinatal complications. As a result, the dilemma between universal screening or selective screening of women at high risk of thyroid dysfunction during pregnancy remains unresolved. Despite this, levothyroxine is also now regularly prescribed by gynaecologists and centres for reproductive medicine. In this context, there is increasing concern regarding the risk of over diagnosis and subsequent potential overtreatment. Taken together, we need to reconsider how thyroid dysfunction should be identified in pregnant women and highlight the arguments for and against the use of levothyroxine in obstetric practices. Our main findings: the mismatch between the guidelines recommendations and the use of LT4 in clinical settings as well as the disparity of criteria between scientific societies from different medical specialties. In conclusion, it is essential to reach agreements between both endocrinologists and obstetricians.

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Recurrent Miscarriage Clinics

Cited by 29 publications

References 33 publications

Genetic association between the HLA-G 14-bp insertion/deletion polymorphism and the recurrent spontaneous abortions in Saudi Arabian women

Genetic association between the HLA-G 14-bp insertion/deletion polymorphism and the recurrent spontaneous abortions in Saudi Arabian women

Aspectos epidemiológicos e obstétricos de mulheres com perdas recorrentes da gravidez em uma maternidade pública do Nordeste do Brasil

Identifying and treating subclinical thyroid dysfunction in pregnancy: emerging controversies

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