Diagnostic factors for recurrent pregnancy loss: an expanded workup.
Arch Gynecol Obstet
; 308(1): 127-142, 2023 07.
Article
em En
| MEDLINE
| ID: mdl-36964323
ABSTRACT
PURPOSE:
There is limited information on the risk factors for recurrent pregnancy loss (RPL).METHODS:
In this study, a patient-based approach was used to investigate the possible involvement and relative relevance of a large number of diagnostic factors in 843 women with RPL who underwent an extensive diagnostic workup including 44 diagnostic factors divided into 7 major categories.RESULTS:
The rates of abnormalities found were (1) genital infections 11.74%; (2) uterine anatomic defects 23.72%; (3) endocrine disorders 29.42%; (4) thrombophilias 62%; (5) autoimmune abnormalities 39.2%; (6) parental karyotype abnormalities 2.25%; (7) clinical factors 87.78%. Six hundred and fifty-nine out of eight hundred and forty-three women (78.17%) had more than one abnormality. The mean number of pregnancy losses increased by increasing the number of the abnormalities found (r = 0.86949, P < 0.02). The factors associated with the highest mean number of pregnancy losses were cervical isthmic incompetence, anti-beta-2-glycoprotein-1 antibodies, unicornuate uterus, anti-prothrombin A antibodies, protein C deficiency, and lupus anticoagulant. The majority of the considered abnormalities had similar, non-significant prevalence between women with 2 versus ≥ 3 pregnancy losses with the exception of age ≥ 35 years and MTHFR A1298C heterozygote mutation. No difference was found between women with primary and secondary RPL stratified according to the number of abnormalities detected (Chi-square 8.55, P = 0.07). In these women, the only factors found to be present with statistically different rates were age ≥ 35 years, cigarette smoking, and genital infection by Ureaplasma.CONCLUSION:
A patient-based diagnostic approach in women with RPL could be clinically useful and could represent a basis for future research.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Aborto Habitual
/
Aborto Induzido
/
Síndrome Antifosfolipídica
Tipo de estudo:
Diagnostic_studies
/
Risk_factors_studies
Limite:
Adult
/
Female
/
Humans
/
Pregnancy
Idioma:
En
Revista:
Arch Gynecol Obstet
Assunto da revista:
GINECOLOGIA
/
OBSTETRICIA
Ano de publicação:
2023
Tipo de documento:
Article
País de afiliação:
Itália