Etiological Factors for First Single Early Pregnancy Loss: Are They Different from Recurrent Pregnancy Loss?

Dasari, Papa; Chitra, Thyagaraju; Garg, Sonal; Kar, Rakhee

doi:10.5005/jp-journals-10006-1944

Cited by 2 publications

(1 citation statement)

References 16 publications

(20 reference statements)

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“…They suggested comprehensive evaluation of the first pregnancy losses for known causes as well so that further pregnancy loss can be prevented. 31 The strength of our study was that a single biopsy was used to diagnose both CE and LPD, and they were processed by a single pathologist. Although we treated our patients with antibiotics after diagnosing them with CE, long-term results of pregnancy outcomes are still to be seen.…”

Section: Discussionmentioning

confidence: 99%

Should Endometrium be Sampled in Cases of Recurrent Pregnancy Loss?

Arora¹,

Sachdeva²,

Rathee³

et al. 2023

Journal of South Asian Federation of Obstetrics and Gynaecology

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Aim:The aim was to determine the prevalence of chronic endometritis (CE) and luteal phase defect (LPD) in women with recurrent pregnancy loss (RPL). Materials and methods: It was an observational study done over 18 months in the tertiary care center in India. Women with two or more than two pregnancy losses were enrolled in the study and underwent an endometrial biopsy. Hematoxylin and eosin (H&E) staining was done on all endometrial biopsies and plasma cells were identified by their classical morphology. Immunohistochemical (IHC) staining was done for CD-138. Identification of one or more plasma cells on the biopsy was diagnosed as CE. Luteal phase defect was diagnosed as a morphological lag on endometrial biopsy dating of more than 2 days compared to the menstrual cycle day. Results: Sixty-five patients were included in the analysis. Approximately 32.31% were CD-138 positive for CE and 58.46% were positive for LPD. The sensitivity and specificity of H&E in diagnosing CE were 38.1% and 70.45%, respectively, taking IHC CD-138 as the gold standard. Approximately 61% with CE also showed LPD on endometrial biopsies. There was also a positive and statistically significant correlation between the number of pregnancy losses and the number of days' lag in LPD (p < 0.0001). Conclusion: Endometrial factors as a cause of unexplained RPL cannot be ignored. It is possible that CE may predispose to LPD or the two may have a cumulative effect leading to RPL. Endometrial biopsy is a cost-effective diagnostic tool, and the treatment of CE and LPD is established and economical. We believe that it is prudent to look for and treat these conditions, which can lead to improvement in pregnancy outcomes. Clinical significance: Endometrial biopsy provides an insight into the etiopathogenesis of RPL and should be a part of the routine workup.

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Section: Discussionmentioning

confidence: 99%

Should Endometrium be Sampled in Cases of Recurrent Pregnancy Loss?

Arora¹,

Sachdeva²,

Rathee³

et al. 2023

Journal of South Asian Federation of Obstetrics and Gynaecology

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Risk and protective factors of miscarriage: Evidence from a nationally representative sample of women in India

Sonu,

Das,

Tony

et al. 2024

Journal of Family Medicine and Primary Care

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Context: Miscarriage is the most distressing complication in early pregnancy, with one in every five pregnant women ending in a miscarriage, and its causes are multifactorial. Aim: This study aimed to find the risk and protective factors of miscarriage among women aged 15–49 years in India by using the National Family Health Survey (NFHS-5) data. Methods and Material: The data were taken from NFHS-5; 53,560 women aged 15–49 years who had reported either a miscarriage (n = 5104) or livebirth (n = 48,456) during the last 12 months preceding the survey were included in the study. Statistical Analysis Used: Various sociodemographic, lifestyle, comorbid, and fertility-related factors were considered in the Poisson regression analysis, and adjusted prevalence ratios were obtained. Results: Significant sociodemographic risk factors were age less than 20 years or more than 34 years, urban residence, primary and higher education levels, wealth index middle and above, and occupation as employed. Muslim religion, Scheduled Tribe, and Other Backward Class castes were statistically significant protective factors. Obesity, severe anemia, hypertension, and thyroid disorder were the significant comorbid risk factors, whereas tobacco chewing was the only significant lifestyle risk factor. A higher number of ever-born children was the fertility-related risk factor, whereas the use of intrauterine devices was a significant protective factor for miscarriage. Conclusions: To reduce the incidence of miscarriage in developing countries like India, the respective governments and healthcare providers should develop intervention programs targeting women in well-educated and high-income families.

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Etiological Factors for First Single Early Pregnancy Loss: Are They Different from Recurrent Pregnancy Loss?

Cited by 2 publications

References 16 publications

Should Endometrium be Sampled in Cases of Recurrent Pregnancy Loss?

Should Endometrium be Sampled in Cases of Recurrent Pregnancy Loss?

Risk and protective factors of miscarriage: Evidence from a nationally representative sample of women in India

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