Weight and recurrent pregnancy loss
If you log out, you will be required to enter your username and password the next time you visit. Luteal phase support with progesterone is of unproven efficacy. Women with recurrent pregnancy loss and a uterine septum should undergo hysteroscopic evaluation and resection. Diagnosis of APS requires the presence of at least 1 of the clinical criteria and at least 1 of the laboratory criteria. The Royal College of Obstetricians and Gynaecologists (RCOG) Guidelines on Management of Recurrent Miscarriage (2001) are consistent with ACOG Guidelines. Please confirm that you would like to log out of Medscape. Perform karyotype of parents with family or personal history of genetic abnormalities. Most spontaneous miscarriages are caused by an abnormal (aneuploid) karyotype of the embryo. At least 50% of all first-trimester spontaneous abortions (SABs) are cytogenetically abnormal. Tests for thyroid stimulating hormone (TSH) and thyroid antibodies. Tests for antiphospholipid antibodies (APLAs), signaling the presence of the autoimmune disease antiphospholipid antibody syndrome (APS), have reportedly been positive in 10-20% of women with early pregnancy losses. Aetna considers any of the following treatments experimental and investigational for recurrent pregnancy loss because they have not been shown to be effective for that indication. Couples with otherwise unexplained recurrent pregnancy loss should be counseled regarding the potential for successful pregnancy without treatment. Exclusion of other coagulopathies as clinically indicated and heparin. Although preimplantation genetic screening (PGS) of a removed blastomere for aneuploidy would theoretically increase the likelihood of embryonic implantation, reports in the literature have been conflicting with regard to the efficacy of this technique.
Imaging studies in the diagnosis of uterine defects include the following. An association between the luteal phase defect and recurrent pregnancy loss is controversial. For couples who have had an SAB due to a suspected genetic cause, the standard of care is to offer genetic counseling. Perform karyotype of the abortus in recurrent cases. If test results are positive for the same antibody on two consecutive occasions 6-8 weeks apart, the patients should be treated with heparin and low-dose aspirin during her next pregnancy attempt. If a diagnosis of luteal phase defect is sought in a woman with recurrent pregnancy loss, it should be confirmed by endometrial biopsy. Cultures for bacteria and viruses and tests for glucose tolerance, thyroid abnormalities, antibodies to infectious agents, anti-nuclear antibodies, anti-thyroid antibodies, paternal human leukocyte antigen status, or maternal anti-parental antibodies are not beneficial and, therefore, are not recommended in the evaluation of otherwise normal women with recurrent pregnancy loss. This policy is based on the recommendations of the American College of Obstetricians and Gynecologists (ACOG, 2001) and the Royal College of Obstetricians and Gynaecologists (RCOG, 2001). Data from uncontrolled, retrospective reviews have suggested that resection of the uterine septum increases delivery rates, although a prospective, controlled trial did not show that surgical correction of uterine abnormalities benefits pregnancy outcomes. Couples with recurrent pregnancy loss should be tested for parenteral balanced chromosome abnormalities. Successful correction of the prolonged screening test with excess phospholipids. However, couples in whom pregnancy loss can be attributed to a balanced translocation may benefit from specific genetic testing by preimplantation genetic diagnosis (PGD). Inability to correct the prolonged screening test with normal platelet-poor plasma. Anatomic uterine defects can cause obstetric complications, including recurrent pregnancy loss, preterm labor and delivery, and malpresentation.
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