Assessment of insulin resistant and the related cardio-metabolic factors in overweight-obese women presented with missed abortion, Baghdad, Iraq

Abstract

Aims: This study aimed to assess the status of insulin resistance (IR) in overweight-obese women presented with missed abortion and to look for the presence of other cardio-metabolic risk factors. Setting and Design: This observational study was carried at Al-Yarmouk Teaching Hospital in Baghdad, Iraq during the period from March 1, 2014, to January 31, 2015. Materials and Methods: A total number of 60 patients presented with missed miscarriage and managed with misoprostol and, dilatation and curettage (D and C) were enrolled in the study. The data of anthropometric and blood pressure were collected. Fasting serum lipid profile, serum glucose, and fasting insulin were determined. IR is assessed by using the homeostatic model assessment-IR (HOMA-IR). The patients were grouped according to the body mass index (BMI) into Group I (BMI <25 kg/m 2 ) and Group II (BMI ≥25 kg/m 2 ). Results: There is the nonsignificant difference between Group I and Group II in the characteristics and the clinical presentations of the patients. Significant high percent of the history of missed miscarriage observed in Group II compared with Group I (35.6% vs. 6.7%, respectively). Group II women significantly needed D and C intervention in addition to misoprostol therapy compared with Group I (75.6% vs. 13.3%) respectively. Although the blood pressure and lipid profile determinants are within normal levels, they significantly higher in Group II compared with Group I. Fasting serum insulin levels and HOMA-IR index are significantly higher in Group II (13.0 ± 0.5 μU/ml and 2.75 ± 0.5 μU/ml) than Group I (12.2 ± 0.3 μU/ml and 2.43 ± 0.11 μU/ml), respectively. Conclusion: Miscarriage overweight-obese women have significant IR as well as alteration in metabolic determinants. Misoprostol per se is not enough to produce spontaneous expulsion of the uterine content and surgical intervention is needed in these women.