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2023 MAR 4 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- Researchers detail new data in pharmacology. According to news reporting out of [...]

2022 OCT 8 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- Researchers detail new data in Gene Therapy. According to news originating from [...]

2021 NOV 25 (NewsRx) -- By a News Reporter-Staff News Editor at Women's Health Weekly -- Exposure in utero to a drug used to prevent miscarriage can lead to an [...]

Q I'm in my late 30s and pretty healthy. My partner and I would like to start a family, but we've been trying unsuccessfully for over a year. Any advice? [...]

Does cerclage actually prevent miscarriage and preterm birth (PTB) as intended? Our purpose here is to examine the scientific evidence that supports or refutes that premise, which as you will [...]

A study was conducted to determine whether misoprostol medical management of early pregnancy failure was more effective than expectant management. The findings suggest that misoprostol appears to be highly effective for treating early pregnancy failures, with few side effects and high patient satisfaction.

The authors have investigated the clinical use of karyotyping spontaneous abortion material. They have demonstrated that the pregnancy loss is caused by the chromosome abnormalities depending on the gestational age and maternal age at the time of the loss.

Pregnant women who had a miscarriage in a previous pregnancy should have an ultrasound scan of their vagina and cervix beginning in the 14th week of pregnancy, according to a study of 177 women. They should only receive a cervical cerclage if the ultrasound scan shows the cervix becoming shorter than 25 millimeters. Cerclage involves tying a suture around the cervix to keep it closed throughout the pregnancy.

Low-dose aspirin does not appear to be beneficial in in preventing miscarriage in pregnant women with antiphospholipid syndrome. This syndrome is defined as recurrent miscarriage in women who have anti-phospholipid antibodies. In a study of 40 such women, the rate of live birth was 80% in those who took aspirin and those who did not.

Women with a history of miscarriage caused by cervical incompetence can be monitored periodically with ultrasound. This would avoid unnecessary treatment with cervical cerclage. Cervical incompetence means the cervix does not stay closed until labor but opens prematurely. Cerclage is a procedure to keep it closed.

Abstract Objective--To determine whether prepregnancy pituitary suppression of luteinising hormone secretion with a luteinising hormone releasing hormone analogue improves the outcome of pregnancy in ovulatory women with a history of [...]

Pregnant women with insulin-dependent diabetes who undergo intensive therapy to control their blood sugar levels may experience rates of miscarriage and birth defects similar to those in the general population. Women in the Diabetes Control and Complications Trial were assigned to either conventional or intensive therapy to bring blood sugar levels as close to normal as possible. Women in the conventional therapy group who became pregnant were switched to intensive therapy. Between 1983 and 1993, 180 women completed 270 pregnancies, resulting in 191 live births. Eight of nine birth defects occurred in infants born to women originally receiving conventional therapy. Intensive therapy may be recommended for all women with insulin-dependent diabetes to improve the outcomes of any future pregnancies.

Immunotherapy administered at high doses early in pregnancy may help prevent miscarriages in women who have a history of miscarriage. A total of 144 women who had three or more first-trimester miscarriages were assigned to one of two treatment groups. The first group of 106 women received the high dose therapy. The women were immunized with mononuclear cells from their partners that had been irradiated by X-ray. The high-dose group received 100 to 200 million cells. The low-dose group received one million cells. The patients were immunized at approximately five weeks' gestation and again two weeks later. Of those in the high-dose group, 83% successfully carried their pregnancies to term. In the low-dose group, 55.3% carried their pregnancies to term. In the high-dose group the success rate was 89.8% for women first immunized within four weeks of gestation. Almost 6% of the women in the high-dose group had twins. For women in the high-dose group who were immunized before four weeks the percentage was even higher: 7.5%.

PURPOSE: Prevention and treatment of pregnancy loss associated with the antiphospholipid syndrome (APS) are controversial. Successful pregnancies have been reported with prednisone and low-dosc aspirin in patients with lupus anticoagulant and anticardiolipin antibodies (aCL), but failure has also been reported. The purpose of this prospective study was to define the efficacy of such combination therapy in the prevention of pregnancy loss related to aCL. PATIENTS AND METHODS: Consecutive pregnant patients with a minimum Of one pregnancy loss and at least two positive aCL deterrainations more then 3 months apart, and in whom other causes of pregnancy loss were ruled out, were included in the study. aCL concentrations were determined by enzyme-linked immunosorbent assay before and during therapy. Patients received prednisone, at a dosage of 40 mg/d, for 4 weeks. The dose was then tapered down 10 mg every 4 weeks, and then to a maintenance dose of 5 mg/d. They also received aspirin, 81 mg/d, throughout the pregnancy. Babies were evaluated during the pregnancy by measurement of fetal heart rate and ultrasonography, and after the delivery by measurement of weight and Apgar scores, and, in some cases, by arterial gasometry. RESULTS: Eleven patients with a mean ([+ or -] SD) age of 33.2 [+ or -] 5.01 years were included. Prior to therapy, the rate of live-born babies was 15.6% (32 previous fetal losses and 5 live-born babies), and, after therapy, it was 100% (12 pregnancies and 12 live-born babies). There were no significant adverse effects to either mothers or babies. All the patients had positive aCL determinations. Nine patients had positive IgG aCL. The levels of the antibodies decreased during treatment in these nine patients. IgM aCL determinations were positive in nine patients. The levels of this isotype decreased in eight patients (90%) during treatment. CONCLUSIONS: Treatment with prednisone and aspirin appears to be efficacious, safe, and economic in the prevention of pregnancy loss and fetal growth retardation in patients with aCL.

OBJECTIVES: The null hypothesis is that treatment of women with recurrent spontaneous abortions with anticoagulation and immunosuppression will not increase the reproductive outcome if it is started preconceptionally. STUDY DESIGN: Ninety-four women with recurrent spontaneous abortion with autoimmune abnormalities oomprised the study group. Group I began autoimmune therapy 48 hours after ovulation: heparin 5000 twice daily, aspirin 80 mg daily, and prednisone 5 mg twice daily, with an increase to 10 mg twice daily when pregnant. Group 11 started the same medication after a positive pregnancy test. Group III received no medication. Controls were 19 women with no autoimmune abnormalities. The frequency of reproductive outcome was subject to multiple comparison by the Duncan test. RESULTS: The percentages of live-born children in groups I, II, and III were 74%, 44%, and 11%, respectively. CONCLUSIONS: Preconception diagnostic work-up and treatment of autoimmune abnormalities in women with histories of recurrent spontaneous abortion is advocated. (Am J OBSTET GYNECOL 1992;166:1787-98.) Key words: Abortion, autoimmune, treatment, preconception

Cervical cerclage involves the use of ligatures (stitches that hold tissues together) around an incompetent cervix to prevent spontaneous abortion. This is an established treatment, but it is unclear whether the benefits outweigh the potential complications in individual cases. The best time for performing cerclage is between 14 and 18 weeks of gestation, as potentially severe complications are more frequent after that time. The type of patient for which the technique is suited and the best surgical technique are disputed. The outcome of 482 cases in which cervical cerclage was performed was reviewed to help clarify these issues. Advanced cervical dilatation at the time of cerclage and a history of previous spontaneous abortion were associated with increased premature deliveries. Premature rupture of membranes (PROM) occurred in 38 percent of the women; this was also related to dilatation at cerclage. The infection rate was significantly higher in cases with greater cervical dilatation and for emergency procedures. In comparing the outcomes of two surgical techniques, the cesarean rate was about twice as high in first-time cases treated with the Shirodkar method compared with the McDonald technique. However, in patients undergoing repeat cerclage, a better outcome, indicated by older gestational age at delivery and higher birth weight, was associated with Shirodkar technique. The study indicates that cerclage outcome is poorer when cervical dilatation has already begun and in emergency situations; the benefits do not outweigh the risks in these cases. Patients with repeat cerclage may do better with the Shirodkar technique. (Consumer Summary produced by Reliance Medical Information, Inc.)

An incompetent cervix (neck of the uterus) is one that does not remain closed throughout pregnancy; the condition is associated with an increased risk of miscarriage. The surgical procedure performed to treat the condition is called 'cerclage', and involves passing ligatures around the cervix to hold it together, much as a drawstring might cinch tight a leather pouch. One approach, the Shirodkar method, is suited for cases with old scars or anatomic defects, as well as for normal cervixes; however, the method is not often used. A report is provided of the outcome of 66 Shirodkar procedures performed on 46 patients (some women had more than one pregnancy) during a 15-year period. The surgical approach is described. Patients underwent cerclage on an elective basis between 13 and 18 weeks' gestation, and on an emergency basis up until 24 weeks. In prior pregnancies of these patients, the fetal survival rate past the first trimester was 35 percent. Results showed that 55 of the 66 pregnancies continued until at least 37 weeks. Only two of the 11 preterm (prior to 37 weeks' gestation) deliveries could even remotely have been due to cervical incompetence. A success rate of 88 percent term deliveries was achieved, with a corrected neonatal survival of 100 percent. Several patients had had many Shirodkar procedures performed; one, as many as five. In no case did complications related to the procedure necessitate a cesarean section. Training in this approach for obstetrical residents is recommended, as is the design of prospective, randomized studies comparing the Shirodkar method with the McDonald technique, the other commonly used procedure. (Consumer Summary produced by Reliance Medical Information, Inc.)

Progesterone is a hormone produced by the corpus luteum (and later by the placenta) which is essential in maintaining pregnancy. Some studies have shown that given early in pregnancy, progesterone can prevent recurrent miscarriage. Most of the controversy surrounding the beneficial effects of progesterone is centered on the type of agent used. The type of progestational agents may vary from study to study. To help clarify this issue, an analysis of all clinical trials using one of the most fully studied progestational agents, 17 alpha-hydroxyprogesterone caproate, is reported. Seven recent controlled trials were found that examined the beneficial effects of hydroxyprogesterone caproate in preventing miscarriage. Six of these studies involved women who were at high risk for miscarriage or preterm birth (delivery before the 37th completed week of pregnancy). There was no evidence that hydroxyprogesterone caproate was useful in preventing miscarriage. However, the rate of preterm birth was reduced, which was reflected by the decreased rate of low-birth-weight infants born to women who took hydroxyprogesterone caproate. There was no significant reduction in the number of infant complications or infant deaths among the women treated with progesterone. Therefore, there is no evidence supporting the beneficial effect of hydroxyprogesterone caproate upon the incidence of miscarriage. (Consumer Summary produced by Reliance Medical Information, Inc.)

Fresh data on Spontaneous Abortion are presented in the report 'Thromboprophylaxis for recurrent miscarriage in women with or without thrombophilia. HABENOX: a randomised multicentre trial.' According to the authors of [...]

'Preconception counseling plays a key role in preparing for a pregnancy. In couples with a history of recurrent early pregnancy loss, counseling is of particular importance because women are invariably [...]

Fertility - High or low levels of a single protein in the womb can prevent implantation or trigger miscarriage. Female infertility and pregnancy loss may be caused by a problem [...]

The antibiotic, called azithromycin, is effective in treating infections such as syphilis, Chlamydia and Ureaplasma urealyticum - a bacterial infection thought to play a significant role in causing preterm labour. […]

The definition, classification, signs and symptoms, causes of miscarriage and ectopic pregnancy are discussed. The risk factors to be taken care of to avoid miscarriages and ectopic pregnancies are also highlighted.