Habitual Abortion

Background and objectivesProgesterone is essential to maintain a healthy pregnancy. Guidance from the Royal College of Obstetricians and Gynaecologists and a Cochrane review called for a definitive trial to test whether or not progesterone therapy in the first trimester could reduce the risk of miscarriage in women with a history of unexplained recurrent miscarriage (RM). The PROMISE trial was conducted to answer this question. A concurrent cost-effectiveness analysis was conducted.Design and settingA randomised, double-blind, placebo-controlled, international multicentre study, with economic evaluation, conducted in hospital settings across the UK (36 sites) and in the Netherlands (nine sites).Participants and interventionsWomen with unexplained RM (three or more first-trimester losses), aged between 18 and 39 years at randomisation, conceiving naturally and giving informed consent, received either micronised progesterone (Utrogestan®, Besins Healthcare) at a dose of 400 mg (two va...

Background and objectivesProgesterone is essential to maintain a healthy pregnancy. Guidance from the Royal College of Obstetricians and Gynaecologists and a Cochrane review called for a definitive trial to test whether or not progesterone therapy in the first trimester could reduce the risk of miscarriage in women with a history of unexplained recurrent miscarriage (RM). The PROMISE trial was conducted to answer this question. A concurrent cost-effectiveness analysis was conducted.Design and settingA randomised, double-blind, placebo-controlled, international multicentre study, with economic evaluation, conducted in hospital settings across the UK (36 sites) and in the Netherlands (nine sites).Participants and interventionsWomen with unexplained RM (three or more first-trimester losses), aged between 18 and 39 years at randomisation, conceiving naturally and giving informed consent, received either micronised progesterone (Utrogestan®, Besins Healthcare) at a dose of 400 mg (two va...

Introducción. Las complicaciones vasculares placentarias usualmente derivan en embarazos de alto riesgo con consecuencias como prematuridad o muerte fetal. Las guías actuales recomiendan sólo el estudio de los anticuerpos antifosfolípidos como trombofilia asociada a las complicaciones obstétricas. Los criterios diagnósticos de Sydney fueron establecidos para homogeneizar la población en los diferentes estudios. En la práctica diaria es frecuente encontrar mujeres con historia de embarazos de alto riesgo pero que no cumplen dichos criterios, por lo que quedarían sub-representadas a la hora de las decisiones terapéuticas. Objetivo. Comparar complicaciones vasculares derivadas de la placenta en mujeres con síndrome antifosfolípido obstétrico (SAFO) y síndrome antifosfolípido obstétrico no criterio (NC-SAFO). Método. Estudio retrospectivo observacional multicéntrico. Se analizaron complicaciones en el segundo y tercer trimestre. Criterios de inclusión clínicos: mujeres de 18-50 años con...

Objective To assess depression, domestic violence and the use of substances in women with recurrent miscarriages. Methods The Abuse Assessment Screen (AAS), the Edinburgh Postnatal Depression Scale (EPDS) and the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) were used to assess violence, depression and the use of substances among women with recurrent miscarriages. The population corresponded to patients receiving prenatal care from June to August 2014. Multiple logistic regression was used to assess the multivariable relationship between depression and sociodemographic, psychosocial and medical characteristics (p < 0,10). Results The prevalence of depression was of 41.3% (95% confidence interval [CI] = 28.3–55.7%). One third of the pregnant women (32.6%) reported emotional or physical violence, and 13% were classified as abusing or addicted to tobacco according to ASSIST. History of psychiatric diseases was associated with depression (p = 0.005). Violence dur...

Tartışma ve Sonuç: CVS ilk trimester de prenatal tanı için kullanılan altın standart testtir. CVS endikasyonlarından bağımsız olarak, fetal sitogenetik analiz sonuçlarının çoğu trizomidir. NT kalınlığı ve kistik higroma olanlarda fetal sitogenetik anomali görülme oranı, fetal kayıp oranı ve tahliye oranı artmaktadır.

Uterus myomlari 30 yasin uzerindeki kadinlarin %20-50’sinde gorulebilen benign tumorlerdir. Tum gebeliklerin yaklasik % 1.4-8.6’sinda uterin myomlar gorulur. Cogunlukla uterus fundus ya da govdesinde yerlesen myomlarin yaklasik % 3’u servikstedir. Submukoz ve subendometriyal myomlar nadiren endometriyumu asarak endometrial kanal icine bir pedikulle birlikte uzayabilirler. Bu duruma gebelik de eslik ediyorsa hastalarin normal spontan vajinal yol ile dogurmalari zor veya imkânsiz hale gelebilmekte ve bircok komplikasyonu beraberinde getirebilmektedir. Bu yazida ultrasonografik olarak servikal kanali kapatan myoma uterili bir missed abortus olgusunda histerotomi ile gebeligin sonlandirilmasi ve es zamanli myomektomi islemi sunulacaktir

Background and objectivesProgesterone is essential to maintain a healthy pregnancy. Guidance from the Royal College of Obstetricians and Gynaecologists and a Cochrane review called for a definitive trial to test whether or not progesterone therapy in the first trimester could reduce the risk of miscarriage in women with a history of unexplained recurrent miscarriage (RM). The PROMISE trial was conducted to answer this question. A concurrent cost-effectiveness analysis was conducted.Design and settingA randomised, double-blind, placebo-controlled, international multicentre study, with economic evaluation, conducted in hospital settings across the UK (36 sites) and in the Netherlands (nine sites).Participants and interventionsWomen with unexplained RM (three or more first-trimester losses), aged between 18 and 39 years at randomisation, conceiving naturally and giving informed consent, received either micronised progesterone (Utrogestan®, Besins Healthcare) at a dose of 400 mg (two va...

Amaç: Abortus imminens 20.gestasyonel haftadan önce servikal değişiklikler olmaksızın vajinal kanama görülmesi olarak tanımlanır ve gebelik sonuçlarını etkileyen bir klinik durumdur. Çalışmamızın amacı abortus imminensin (Aİ) gebeliğin birinci veya ikinci trimesterinde izlenmesinin obstetrik sonuçlara etkisini araştırmaktır. Gereç ve Yöntem: Bu retrospektif çalışmaya Ocak 2017 ve Aralık 2019 yılları arasında erken gebelik servisine Aİ nedeniyle yatışı olan 831 tekil gebelik dahil edildi. Aİ tanısını aldığı gestasyonel haftaya göre olgular 1. ve 2. trimester (Grup 1 ve Grup 2) olmak üzere ikiye ayrılarak obstetrik sonuçlar karşılaştırıldı. Bulgular: Toplam 831 olgunun 622’si (%75,8) grup 1’e ve 209’u (%25,2) grup 2’ye ait idi. Grup 1’dekilerin %51,1’inde ve grup 2’dekilerin %44,2’sinde hematom mevcuttu (p=0,075). Gebeliğin sonlandığı gestasyonel hafta grup 2’dekilerde daha uzundu (33,04±8,8 karşın 28,14±13,94, p

Background and objectivesProgesterone is essential to maintain a healthy pregnancy. Guidance from the Royal College of Obstetricians and Gynaecologists and a Cochrane review called for a definitive trial to test whether or not progesterone therapy in the first trimester could reduce the risk of miscarriage in women with a history of unexplained recurrent miscarriage (RM). The PROMISE trial was conducted to answer this question. A concurrent cost-effectiveness analysis was conducted.Design and settingA randomised, double-blind, placebo-controlled, international multicentre study, with economic evaluation, conducted in hospital settings across the UK (36 sites) and in the Netherlands (nine sites).Participants and interventionsWomen with unexplained RM (three or more first-trimester losses), aged between 18 and 39 years at randomisation, conceiving naturally and giving informed consent, received either micronised progesterone (Utrogestan®, Besins Healthcare) at a dose of 400 mg (two va...

Introducción: La pérdida gestacional recurrente (PGR) es Recurrent pregnancy lost (RPL) is a common condition that una patología frecuente, que causa gran impacto en las causes great impact on partners leading frustration, parejas conllevando frustración, ansiedad, depresión, gastos anxiety, depression, excessive spending and even breaks excesivos y hasta rupturas de la relación de pareja. Su in the relationship. Its etiology is multifactorial and often can etiología es multicausal y frecuentemente no se logra not be determined. This paper describes a case of a patient determinar. Se presenta el caso de una paciente con PGR who after six RPL losses, in the seventh pregnancy is quien luego de seis pérdidas gestacionales, en el séptimo detected high positive antiphospholipid antibodies. She embarazo se detectaron anticuerpos antifosfolípidos altos, receive thromboprophylaxis twice a week until 32 weeks of recibiendo tratamiento de tromboprofilaxis doble hasta la gestational age, produced an healthy preterm newborn semana 32, obteniéndose un producto pretérmino vivo y with a good prognosis. We discuss difficulties in the sano que evolucionó satisfactoriamente. Se discuten diagnostic accuracy and treatment modalities described. dificultades para la precisión diagnóstica y las modalidades [Salazar HA, Lancheros EA, Becerra CH. Use of low de tratamiento descritos. [Salazar HA, Lancheros EA, molecular weight heparin and aspirin in a patient with Becerra CH. Uso de heparina de bajo peso molecular y antiphospholipidsyndrome and recurrent pregnancy loss. aspirina en una paciente con síndrome antifosfolípido y pér

Objective To assess depression, domestic violence and the use of substances in women with recurrent miscarriages. Methods The Abuse Assessment Screen (AAS), the Edinburgh Postnatal Depression Scale (EPDS) and the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) were used to assess violence, depression and the use of substances among women with recurrent miscarriages. The population corresponded to patients receiving prenatal care from June to August 2014. Multiple logistic regression was used to assess the multivariable relationship between depression and sociodemographic, psychosocial and medical characteristics (p < 0,10). Results The prevalence of depression was of 41.3% (95% confidence interval [CI] = 28.3–55.7%). One third of the pregnant women (32.6%) reported emotional or physical violence, and 13% were classified as abusing or addicted to tobacco according to ASSIST. History of psychiatric diseases was associated with depression (p = 0.005). Violence dur...

Background and objectivesProgesterone is essential to maintain a healthy pregnancy. Guidance from the Royal College of Obstetricians and Gynaecologists and a Cochrane review called for a definitive trial to test whether or not progesterone therapy in the first trimester could reduce the risk of miscarriage in women with a history of unexplained recurrent miscarriage (RM). The PROMISE trial was conducted to answer this question. A concurrent cost-effectiveness analysis was conducted.Design and settingA randomised, double-blind, placebo-controlled, international multicentre study, with economic evaluation, conducted in hospital settings across the UK (36 sites) and in the Netherlands (nine sites).Participants and interventionsWomen with unexplained RM (three or more first-trimester losses), aged between 18 and 39 years at randomisation, conceiving naturally and giving informed consent, received either micronised progesterone (Utrogestan®, Besins Healthcare) at a dose of 400 mg (two va...

Objective: To standardize the investigation and clinical management of women with laboratory and/or clinical abnormalities suggestive of thrombophilia, in order to optimize antithrombotic approach and indication of laboratory tests. Methodology: A discussion was carried out among 107 physicians (gynecologists/obstetricians, hematologists and vascular surgeons) present at a forum held at the Hospital Israelita Albert Einstein, in São Paulo (SP), Brazil. As a minimum criterion, 80% agreement was established in the voting to each recommendation of conduct in the final document. The cases in which there was agreement below 80% were discussed again, reaching a consensual agreement of conduct for the document writing. Conclusion: The standardization of an institutional consensus of suggestions of clinical approach contributes to a better management of the group to be evaluated and minimizes risks of intercurrent events. This was the first national consensus on the investigation of thrombophilia in women.