Blog dedicated to the continuous education in Gynecology and Endocrinology

 

MISCARRIAGE AND ABORTION

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Male chromosomal implication in recurrent spontaneous abortions
El Kamel-Lebbi I

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Higher frequency of anti-thyroid antibodies in patients with recurrent spontaneous abortion may stem from impaired vitamin D3 metabolism
Hedayat Z

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Short-term follow-up of voluntary abortion in an Italian centre: a prospective analysis of 186 cases
Salvador S

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Antithyroid antibodies and Recurrent Pregnancy Loss
Spitaleri M

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Risk of spontaneous miscarriage in euthyroid women with thyroid autoimmunity undergoing in-vitro fertilization: a systematic review and a meta-analysis
Toulis Konstantinos

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Are We Missing Out Evaluation of Paternal Chromosomal Abnormality In Recurrent Miscarriage? Varicocele and Sperm FISH
Turp AB

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Glutathione S-transferase M1 and T1 Polymorphisms and the Risk of Recurrent Early Pregnancy Loss in Women with High Perceived Stress
Tutchenko TN

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Effects of early pregnancy loss on hormone levels in the subsequent menstrual cycle

Jukic, Anne Marie (contact); Weinberg, Clarice; Wilcox, Allen; Baird, DD

Previous studies of hormone patterns after clinical miscarriage suggest reduced pituitary function. Hormonal effects of very early pregnancy loss (before six weeks gestation) have not been described. We used within-woman differences between menstrual cycles in urinary hormone measurements from women in the North Carolina Early Pregnancy Study to describe hormonal changes after very early pregnancy loss (n=28 early losses; 80 non-conception comparison cycles). more

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Recurrent Miscarriage and hCG Supplementation: A Review

Carp, Howard DGYE-2010-0106[488779]

Human chorionic gonadotrophin (hCG) has been used to prevent subsequent miscarriages after previous recurrent miscarriages. In addition to the luteotrophic effects, hCG has uterine immune and autocrine actions. hCG also affects cytokine expression. A Cochrane database systematic review has indicated that hCG seems to prevent further miscarriages, (OR for miscarriage = 0.26, 95% CI 0.14-0.52). more

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Are progestins effective for threatened abortion?

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Carp Howard

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Facchinetti Fabio

Are estrogens neuroprotective?

Carp Howard- Facchinetti Fabio

(14th World Congress of Gynecological Endocrinology – March 4-7 2010)

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MATERNAL AND PERINATAL OUTCOME IN WOMEN WITH THREATENED MISCARRIAGE IN THE FIRST TRIMESTER: A SYSTEMATIC REVIEW.

2) BJOG. 2009 Nov 26.

Saraswat L, Bhattacharya S, Maheshwari A, Bhattacharya S.

Background Threatened miscarriage is a common complication in the first trimester of pregnancy and is often associated with anxiety regarding pregnancy outcome.

Objective We undertook a systematic review to explore the effects of threatened miscarriage in the first trimester on maternal and perinatal outcomes. Search strategy An electronic literature search using MEDLINE and EMBASE, and bibliographies of retrieved primary articles. No language restrictions were applied. Selection criteria All studies analysing outcomes of first-trimester bleeding where viability was confirmed on ultrasound or the pregnancy continued beyond viability.

Data collection and analysis Two review authors independently selected studies and extracted data on study characteristics, quality and accuracy. Meta-analysis was performed using Review Manager software Main outcome measures The outcome was broadly categorised into maternal and perinatal outcomes. The chief maternal outcomes included pre-eclampsia/eclampsia or pregnancy-induced hypertension, antepartum haemorrhage, preterm prelabour rupture of membranes (PPROM) and mode of delivery. The perinatal outcomes evaluated were preterm delivery, low birthweight, intrauterine growth restriction, perinatal mortality, indicators of perinatal morbidity (Apgar scores and neonatal unit admission) and presence of congenital anomalies.

Main results Fourteen studies met the inclusion criteria. Women with threatened miscarriage had a significantly higher incidence of antepartum haemorrhage due to placenta praevia [odds ratio (OR) 1.62, 95% CI 1.19, 2.22] or antepartum haemorrhage of unknown origin (OR 2.47, 95% CI 1.52, 4.02) when compared with those without first-trimester bleeding. They were more likely to experience PPROM (OR 1.78, 95% CI 1.28, 2.48), preterm delivery (OR 2.05, 95% CI 1.76, 2.4) and to have babies with intrauterine growth restriction (OR 1.54, 95% CI 1.18, 2.00). First-trimester bleeding was associated with significantly higher rates of perinatal mortality (OR 2.15, 95% CI 1.41, 3.27) and low-birthweight babies (OR 1.83, 95% CI 1.48, 2.28).

Authors’ conclusions Threatened miscarriage in the first trimester is associated with increased incidence of adverse maternal and perinatal outcome.

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