Diagnosis Of Recurrent Spontaneous Abortion Research Articles

Advances of Genetic Testing Technology in Etiology Diagnosis of Recurrent Spontaneous Abortion

Advances of Genetic Testing Technology in Etiology Diagnosis of Recurrent Spontaneous Abortion

Molecular cytogenetic analysis of partial monosomy 10p and trisomy 10q resulting from familial pericentric inversion (10): a first case report in Chinese population

BackgroundChromosome aberrations of 10p monosomy and 10q trisomy resulting from parental pericentric inversion 10 are extremely rare, and to date, very few reports have been published on the matter.Case PresentationA 30-year-old pregnant woman with recurrent pregnancy loss is enrolled in this research. In this pregnancy, spontaneous abortion occurred in the first trimester of her pregnancy. Chromosomal microarray analysis of the abortion tissue showed a partial 10p monosomy (arr[GRCh37] 10p15.3p11.21(100,047_34,848,853) × 1) and a duplication of 10q (arr[GRCh37] 10q26.13q26.3(126,093,990_135,426,386) × 3). Further parental karyotype analysis indicated that the chromosomal abnormalities in the fetus was resulted from paternal pericenric inversion inv(10)(p11.21q26.13). This study presents the first case of a large deletion of 10p combined with 10q trisomy, resulting in pregnancy loss. Of these two manifestations, the large deletion of chromosome 10p may be the primary reason for spontaneous abortion in this subject.ConclusionsThis study presents the first case of partial 10p monosomy associated with 10q trisomy in Chinese population. It provides more information on the chromosome aberration of 10p monosomy and 10q trisomy and further strengthens the application value of microarray in the molecular etiological diagnosis of recurrent spontaneous abortion.

Recurrent Pregnancy WastageHistology of Products of Conception

Background: Histopathologic examination of products of spontaneous abortion is done to identify pregnancy- molar or ectopic. Also, in the perspective of recurrent abortion, additional diagnostic information can be obtained. We studied products of conception with the aim to find if it is of any value in recurrent pregnancy wastage. Methods: Data was obtained from patients with the diagnosis of recurrent spontaneous abortion. The samples were examined macroscopically and microscopically by a competent histopathologist. Results: Age of the patients ranged from 23-36 years. Majority of the recurrent abortions occurred during 10-15 weeks of gestation accounting for 41 (65.07%) cases. Recurrences ranged from third to fifth time loss contributing to 44 (69.84%), 14 (22.22%) and 5 (7.93%) cases respectively. Villous oedema of chorionic villi were seen in 30 (47.61%) cases. Abnormal vascularity in the form of complete avascularity of villi was observed in 8 (12.69%) cases. 50 (79.36%) cases showed fibrinoid degeneration. Amongst the 50 cases, 30 (60%) cases showed both perivillous and intravillous fibrin while 20 (40%) cases showed only perivillous fibrin deposition. 30 cases (47.61%) showed evidence of chronic villitis. The 30 cases were subdivided into “infectious villitis“ and “villitis of unknown etiology“ (VUE). Infectious villitis was seen in only 1 case (3.3%) which showed presence of toxoplasmal cysts and plasma cell infiltration. Deciduitis was observed in 31 (49.20%) cases. Decidual necrosis was seen in 23 (36.50%) cases. 3 (4.76%) cases of partial mole were diagnosed. 4 (6.34%) cases each of syncitial knots and villous infarction were seen. We did not encounter any cases of chronic intervillositis and chronic endometritis. Conclusion: It is rational to perform histopathological examination routinely for all recurrent miscarriages.

Aspirin or heparin or both in the treatment of recurrent spontaneous abortion in women with antiphospholipid antibody syndrome: a meta-analysis of randomized controlled trials

Objective: This study was designed to evaluate the efficacy of aspirin or heparin or both in the treatment for recurrent spontaneous abortion (RSA) in women with antiphospholipid antibody syndrome (APS).Methods: Systematic searches for randomized clinical trials (RCTs) evaluating on live birth and preterm delivery, preeclampsia, intrauterine growth restriction, gestational diabetes, bleeding of RSA with APS patients receiving aspirin, and heparin therapy were carried out, from PubMed, EMBASE, ScienceDirect, and CNKI. Related data were extracted from eligible studies and then subjected to Reviewer Manage 5.3 for analysis. Relative risk (RR) and its 95% confidence interval were calculated.Results: Nineteen publications with randomized controlled trials were selected for this study, which included a total of 1251 pregnant patients with diagnosis of RSA with APS. With respect to live birth, it was remarkably improved in aspirin plus heparin or heparin alone group [RR =1.23, 95% CI (1.12–1.36), p < .0001; RR = 1.18, 95% CI (1.03–1.35), p = .02]; aspirin alone group, however, there was no statistically significant difference compare to placebo [RR = 0.97, 95% CI (0.80–1.16), p = .71]. Meanwhile, aspirin plus heparin therapy did not significantly reduce the risk of recurrent placenta-mediated pregnancy complications including preterm birth, intrauterine growth retardation (IUGR), gestational diabetes, and minor bleeding. A beneficial therapeutic effect of heparin alone therapy was found on preventing preterm birth and low-dose aspirin plus heparin therapy was significant reduce the risk of preeclampsia.Conclusion: An improvement of pregnancy outcomes in women with RSA and APS can be achieved by treatment strategies combining low-dose aspirin plus heparin or heparin alone. Aspirin alone, by contrast, seemed inferior to other treatments in achieving more live birth.

The clinical value of the detection of obstetrical thrombophilia in the diagnosis of recurrent spontaneous abortion

The obstetrical thrombophilia will lead to the dysfunction of coagulation and fibrinolysis system, which increases the risk of thrombosis in parturient women. It can even cause pregnancy complications, such as abortion, premature birth, placental abruption. The relationship between thrombophilia and recurrent spontaneous abortion, and the significance of some relevant detection of obstetrical thrombophilia in the diagnosis of recurrent spontaneous abortion (RSA) are reviewed in the study.(Chin J Lab Med, 2017, 40: 856-859) Key words: Recurrent spontaneous abortion; Hereditary thrombophilia; Acquired thrombophilia

Serum biomarker analysis in patients with recurrent spontaneous abortion.

Recurrent spontaneous abortion (RSA) occurs in 1–5% of parturients. The sustained therapy and research for RSA is expensive, which is a serious issue faced by both patients and doctors. The aim of the present study was to detect protein expression profiles in the serum of RSA patients and healthy controls, and to identify potential biomarkers for this disease. A 1,000-protein microarray consisting of a combination of Human L-507 and L-493 was used. The microarray data revealed that eight serum protein expression levels were significantly upregulated and 143 proteins were downregulated in RSA patients compared with the healthy controls. ELISA individually validated 5 of these 151 proteins in a larger cohort of patients and control samples, demonstrating a significant decrease in insulin-like growth factor-binding protein-related protein 1 (IFGBP-rp1)/IGFBP-7, Dickkopf-related protein 3 (Dkk3), receptor for advanced glycation end products (RAGE) and angiopoietin-2 levels in patients with RSA. Sensitivity and specificity analyses were calculated by a receiver operating characteristics curve, and were revealed to be 0.881, 0.823, 0.79 and 0.814, with diagnostic cut-off points of 95.44 ng/ml for IFGBP-rp1, 32.84 ng/ml for Dkk3, 147.27 ng/ml for RAGE and 441.40 ng/ml for angiopoietin-2. The present study indicated that these four proteins were downregulated in RSA samples and may be useful as biomarkers for the prediction and diagnosis of RSA. Subsequent studies in larger-scale cohorts are required to further validate the diagnostic value of these markers.

English

INTRODUCTION: Recurrent spontaneous abortion of unknown etiology provided fundamental insight into process of embryogenesis, and implantation. It is also a frustrating and emotionally charged clinical problem. Hormonal imbalances are important cause of recurrent pregnancy loss, in the 1st trimester as well as in 2ndtrimester. Thyroid diseases are the commonest disorders affecting women of reproductive age group.They constitute the commonest endocrine disorder complicating pregnancy. In women incidence of hypothyroidism diagnosed before pregnancy is 1%. Maternal and fetal complications have been found to be higher in this population. In women incidence of hypothyroidism diagnosed before pregnancy is 1%. Maternal and fetal complications have been found to be higher in this population. OBJECTIVE: We studied the Thyroid profile in patients of recurrent abortion. MATERIALS AND METHODS: 60 non pregnant healthy women with complaints of vaginal bleeding, pelvic pain, tissue discharge up to 8, 16, and 22 weeks with 20 subjects in each group. Details of history, physical findings, laboratory evaluation and medication were noted from their case records and verified. 60 healthy, pregnant women who were at same gestational age and then reached the term and had successful pregnancy outcome, were selected as controls. The controls were not under any regimen and were free from any chronic illness. Elisa method was used for estimation of thyroid hormones. RESULTS: We studied 60 non pregnant healthy women (27±2.6 years) with established diagnosis of recurrent spontaneous abortion. Serum TT3, fT3, TT4, fT4 was found to be significantly low in cases as compared to controls. 21 women out of 60 i.e. 35 % showed overt hypothyroidism. Majority of these cases were showing recurrent pregnancy lost in between 8-16 weeks of gestation when their history was traced. CONCLUSION: Hypothyroidism is frequent cause in recurrent pregnancy loss. Severe maternal hypothyroidism early in gestation is strongly associated with fetal distress and abortion. We suggest evaluation of maternal TSH as a routine test for screening hypothyroidism to potentially improve the pregnancy outcome and maternal well being.

Application of gene array chip in diagnosis of cytogenetics of recurrent spontaneous abortion

To investigate clinical value of single nucleotide polymorphism array (SNP-array) gene chip technique in diagnosis of genetics of recurrent spontaneous abortion(RSA). From January to October 2012, the 26 patients with more than twice of spontaneous abortion in Huzhou Maternal and Child Health Care Hospital were enrolled in this study(RSA group). Meanwhile 20 cases with induced abortion were taken as control group. All aborted tissues were analyzed with conventional cytogenetic karyotyping and SNP-array, respectively. Chorionic villus chromosomal examination was successfully done in 19 cases (73%, 19/26) , which 10 cases were found with chromosomal anomaly, the overall detection rate is 10/19. However, SNP-array analysis was successfully performed in all 26 cases. The overall rate of detection was 100%, and abnormalities were found in 15 cases, which reached the detection rate was 58% (15/26). Chorionic villus chromosomal examination was successfully done in 16 cases (16/20) in control group, and none of the resluts was chomosomal anomaly; SNP-array analysis was successfully performed in all 20 cases (20/20), and none was found abnormalities. SNP-array gene chip technique showed highly accurate feature, which could be used in cytogenetic diagnosis of recurrent spontaneous abortion.

Assays for the diagnosis of recurrent spontaneous abortion of immune origin

Assays for the diagnosis of recurrent spontaneous abortion of immune origin

Current Clinical Options for Diagnosis and Treatment of Recurrent Spontaneous Abortion

Recurrent spontaneous abortion is a health care concern occurring in 2-5% of couples' attempting to reproduce. The observed frequency of recurrent abortion is higher than that expected by chance (0.3%), which implies an underlying cause(s) contributing to the recurrent Effective treatment is needed for couples experiencing recurrent spontaneous abortion. Before effective treatment can be instituted, the cause of pregnancy loss must be determined. The underlying causes of recurrent spontaneous abortion are not entirely clear. As a result, controversy regarding the appropriate evaluation and treatment of couples experiencing recurrent spontaneous abortion ex'ists. To approach this controversy the American Society for Reproductive Immunology, under the direction of its President, Thomas J Gill, 111, established the committee on Clinical Guidelines Recommendation Committee for Recurrent Spontaneous Abortion in 1995. The members of the Committee were: Carolyn Coulam, Chairman; Alan Beer; William H. Kutteh; David A Clark; Robert Silver; Joanne Kwak; and Mary Stephenson. Each member was asked to submit guidelines for both diagnosis and treatment of recurrent spontaneous abortion. The guidelines were collated by the chairman and circulated to the members of the committee for additions and corrections. A final corrected report was recirculated to the committee members, and the committee met at the time of the 16th Annual Meeting of the American Society of Reproductive Immunology on June 23, 1996, in Knoxville, Tennessee, for a consensus conference. The final manuscript emerging from the consensus conference was given to the Council of the American Society for Reproductive Immunology for their consideration. Additions and corrections made by the council were incorporated into the report, and the report was recirculated to the new council and committee members before the Interim Executive Council Meeting on December 7, 1996, in Pittsburgh, Pennsylvania. The Committee presents options for diagnosis and treatment of recurrent spontaneous abortion. The Clinical Options for Diagnosis of Recurrent Spontaneous Abortion are based on an evaluation determined by risk factors of recent experimental and empirical research. Risk factors for recurrent spontaneous abortion in

Occurrence of ectopic pregnancy among women with recurrent spontaneous abortion.

Ectopic pregnancy is a major health problem accounting for about 10% of all maternal mortality. To determine whether patients with a history of recurrent spontaneous abortion (RSA) have a higher frequency of ectopic pregnancy than the general population, the obstetrical histories of 630 patients with a diagnosis of RSA from two centers were studied. Thirty-eight of 376 USA women, (10%) and 10 of 193 British women (5%) previously had suffered an ectopic pregnancy. These data provide an overall prevalence of 9% for ectopic pregnancy among patients who recurrently abort. The total number of pregnancies was 1,716 in the USA group and in the British group was 1,270, for a total of 2,986 including live births, stillbirths, abortions, hydatidiform moles, and ectopic pregnancies. In the US series, 45 of the 1,716 pregnancies were ectopic. If these women had the same relative proportion of ectopic pregnancies as the general population, there should have been 20.6 ectopic pregnancies. This represents a 2.2-fold increase in patients with a history of RSA. There was no association between pregnancy order and occurrence of ectopic pregnancy. The prevalence of known risk factors for ectopic pregnancy in patients with a history of ectopic pregnancy was PID, 3%; tubal surgery, 20%; and used IUD, 3%. Seventy-four percent of the women had no identifiable risk factor. These results suggest a comorbidity for ectopic pregnancy and RSA which may indicate shared etiologies.

Pregnancy outcome after diagnosis of recurrent spontaneous abortion

Pregnancy outcome after diagnosis of recurrent spontaneous abortion