RECURRENT MISCARRIAGE Dr.F Mardanian MD. CASE CASE 35 Y G5L1Ab4 G1=L1 G2=16weeks G3=8weeks G4=12weeks G5=16weeks BW=105kg 35 Y G5L1Ab4 G1=L1 G2=16weeks.

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Presentation transcript:

RECURRENT MISCARRIAGE Dr.F Mardanian MD

CASE CASE 35 Y G5L1Ab4 G1=L1 G2=16weeks G3=8weeks G4=12weeks G5=16weeks BW=105kg 35 Y G5L1Ab4 G1=L1 G2=16weeks G3=8weeks G4=12weeks G5=16weeks BW=105kg Vaginal Exam  Uterus>NL Vaginal Exam  Uterus>NL Sonography(TVS)= Uterus>NL Sonography(TVS)= Uterus>NL Hysterosalpingography=NL Hysterosalpingography=NL Lab Data: Lab Data: TSH=NL Prolactin=NL Anticardiolipin Ab=NL Lupus Anticoagulant Ab=NL GTT=NL ProteinC,S- AntithrombinIII=NL TSH=NL Prolactin=NL Anticardiolipin Ab=NL Lupus Anticoagulant Ab=NL GTT=NL ProteinC,S- AntithrombinIII=NL Pathologic Findings=Chorionic Villosities Pathologic Findings=Chorionic Villosities Parents Karyotype=NL Parents Karyotype=NL

ETIOLOGY GGGGenetics 3-5% Couples with Recurrent Miscarriage PGD/S AAAAnatomic IIIImmunologic TTTThrombophilic EEEEndocrine IIIInfectious factors EEEEnviromental Factors UUUUnexplained 50% PGD/S

PLAN

What is the prognosis of subsequent pregnancy after 3times unexplained Abortion? What is the prognosis of subsequent pregnancy after 3times unexplained Abortion? 30-40% risk of repeated Abortion.

When should we evaluate cause of recurrent Abortion? (After 2times Abortion) Detected FHR in previous pregnancies. M Maternal age >35. I Infertility. N Normal karyotype of gestational tissue.

F First Trimester=50% chromosomal abnormality. E Early Abortion=70% chromosomal abnormality. What is the relationship between Gestational Age and cause of Abortion?

What is the relationship between Obesity and Recurrent Miscarriage? Body Mass Index>=30 I Insuline Resistance.

20-25% increased risk for first trimester Miscarriage. nsuline Resistance. Is there any relationship between PCO and Recurrent Miscarrige?

Infectious factors: Which Lab Data is necessary? C Cervical culture E Endometrial biopsy Specially for patiens with Cervicitis- Chronic Bacterial Vaginosis-PID

What is the role of Cerclage in Recurrent Miscarriage? History of second trimester Pregnancy Loss. Increased Shortening of cervix in Pregnancy.

What is the first choice Treatment in Thrombophilia? HEPARIN HEPARIN

What is the miscarriage rate in patients with ADENOMYOSIS? 1 11% M Mechanism:Nitric Oxide.

What is the Role of Pathology In Recurrent Miscarriage?

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