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RECURRENT MISCARRIAGE Dr.F Mardanian MD

Explore the case study of a 35-year-old woman with recurrent miscarriages, covering etiology, prognosis, risk factors, and treatment options. Learn about genetic, anatomic, immunologic, and thrombophilic factors influencing miscarriage. Understand the importance of evaluating causes after multiple miscarriages.

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RECURRENT MISCARRIAGE Dr.F Mardanian MD

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  1. RECURRENTMISCARRIAGEDr.FMardanian MD

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

  3. ETIOLOGY • Genetics 3-5% Couples with Recurrent Miscarriage PGD/S • Anatomic • Immunologic • Thrombophilic • Endocrine • Infectious factors • Enviromental Factors • Unexplained 50% PGD/S

  4. PLAN

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

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

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

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

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

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

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

  12. What is the first choice Treatment in Thrombophilia? • HEPARIN

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

  14. What is the Role of Pathology In Recurrent Miscarriage?

  15. THANK YOU…

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