Unsuspected Pregnancy Loss in Healthy Women

Whittaker, P. G.; Taylor, Amy; Lind, T.

doi:10.1016/s0140-6736(83)92865-9

Cited by 140 publications

(45 citation statements)

References 7 publications

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“…This study recorded a miscarriage rate of 13.7% which compares very favourably with our overall miscarriage rate of 11%. Other studies have reported early miscarriage rates affecting between 8% (Whittaker et al, 1983) and 61% (Edmonds et al, 1982) of pregnancies. Consequently, though patients in the multi-agent group appeared to be at greater risk of miscarriage (18%) than those in the single agent group (8%), it is unlikely that they are at greater risk than that of the general population.…”

Section: Miscarriagesmentioning

confidence: 92%

The effect of early pregnancy following chemotherapy on disease relapse and foetal outcome in women treated for gestational trophoblastic tumours

et al. 2002

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Little literature exists on the safety of early pregnancy following chemotherapy. Here we assess the rate of relapse and foetal outcome in women who have completed single and multi-agent chemotherapy for gestational trophoblastic tumours. The records of 1532 patients treated for persistent gestational trophoblastic tumours at Charing Cross Hospital between 1969 and 1998 were reviewed. Patients were defined as receiving single agent or multi-agent treatment. Relapse rates and foetal outcome were reviewed in the 230 patients who became pregnant within 12 months of completing chemotherapy. In the single agent group 153 (22%) of 691 patients conceived early. Three subsequently relapsed. In the multi-agent group, 77 (10%) of 779 patients conceived early, two then relapsed. Relapse rates were 2% (3 out of 153) and 2.5% (2 out of 77) for each group compared to 5% and 5.6% in the comparative non-pregnant groups. Outcomes of 230 early pregnancies: 164 (71%) delivered at full term, 35 (15%) terminations, 26 (11%) spontaneous abortions, three (1.3%) new hydatidiform moles and two (1%) stillbirths. Early pregnancies were more common in the single agent group (P50.001), but spontaneous miscarriages and terminations were more likely to occur in the multi-agent group (P=0.04 and 0.03, respectively). Of the fullterm pregnancies, three (1.8%) babies were born with congenital abnormalities. Patients in either group who conceive within 12 months of completing chemotherapy are not at increased risk of relapse. Though, we still advise avoiding pregnancy within 12 months of completing chemotherapy, those that do conceive can be reassured of a likely favourable outcome.

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Section: Miscarriagesmentioning

confidence: 92%

The effect of early pregnancy following chemotherapy on disease relapse and foetal outcome in women treated for gestational trophoblastic tumours

et al. 2002

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“…Firstly, data presented as embryo survival probabilities at different times post-fertilization 55, 58, 59, 61, 63 are fecundabilities, i.e., successes per cycle, not per fertilised embryo. Secondly, for reasons that are unclear, data from Whittaker 60 and Leridon 18 were excluded from the modelling analysis and the data from an earlier Wilcox report 55 were included twice since this preliminary data had been incorporated into the later report 63 . Thirdly, the modelled data were normalised to a survival probability of 0.287 at 21 days post-fertilization.…”

Section: What the Data Saymentioning

confidence: 99%

Early embryo mortality in natural human reproduction: What the data say

Jarvis

2016

F1000Res

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It is generally accepted that natural human embryo mortality during pregnancy is high – losses of 70% and higher from fertilisation to birth are frequently claimed. The first external sign of pregnancy occurs two weeks after fertilisation with a missed menstrual period. Establishing the fate of embryos before this is challenging, and hampered by a lack of data on the efficiency of fertilisation under natural conditions. Four distinct sources are cited to justify quantitative claims regarding embryo loss: (i) a hypothesis published by Roberts & Lowe in The Lancet is widely cited but has no quantitative value; (ii) life table analyses give consistent assessments of clinical pregnancy loss, but cannot illuminate losses at earlier stages of development; (iii) studies that measure human chorionic gonadotrophin (hCG) reveal losses in the second week of development and beyond, but not before; and (iv) the classic studies of Hertig and Rock offer the only direct insight into the fate of human embryos from fertilisation under natural conditions. Re-examination of Hertig’s data demonstrates that his estimates for fertilisation rate and early embryo loss are highly imprecise and casts doubt on the validity of his numerical analysis. A recent re-analysis of hCG study data suggests that approximately 40-60% of embryos may be lost between fertilisation and birth, although this will vary substantially between individual women. In conclusion, it is clear that some published estimates of natural embryo mortality are exaggerated. Although available data do not provide a precise estimate, natural human embryo mortality is lower than is often claimed.

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“…The proportion of early pregnancie s not becoming clinically apparent varied from 8 OJo (19) to 57 OJo (20). In a later study , in which a very sensitive assay was used, the rate of early pregnancy loss was 22 OJo when the total pregnancy loss, including clinically recognized spontaneous abortions, was 31 OJo (21).…”

Section: Frequency Of Spontaneous Abortionmentioning

confidence: 97%

“…Some of the variation in the rate of very early abortion may be due to the different sensitivity and specificity of the used laboratory assays (19,21). For example , cross-reacti vity with urinary human luteinizing hormone or its degraded fragments may have caused false positive results in earlier studies (21).…”

Section: Frequency Of Spontaneous Abortionmentioning

confidence: 99%

Effects of parental occupational exposures on spontaneous abortion and congenital malformation.

Hk¹

1990

Scand J Work Environ Health

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Unsuspected Pregnancy Loss in Healthy Women

Cited by 140 publications

References 7 publications

The effect of early pregnancy following chemotherapy on disease relapse and foetal outcome in women treated for gestational trophoblastic tumours

The effect of early pregnancy following chemotherapy on disease relapse and foetal outcome in women treated for gestational trophoblastic tumours

Early embryo mortality in natural human reproduction: What the data say

Effects of parental occupational exposures on spontaneous abortion and congenital malformation.

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