recurrent pregnancy loss.pptx
•Download as PPTX, PDF•
0 likes•22 views
Recurrent pregnancy loss is defined as three or more consecutive miscarriages before 20 weeks. The main investigations recommended are testing for antiphospholipid antibodies, hysterosalpingography or sonohysterography to check for uterine anomalies, karyotyping of both parents and any fetal tissue to check for genetic abnormalities, and checking the thyroid, glucose, and thrombophilia profiles. The results of these tests can help identify causes like antiphospholipid syndrome, structural uterine issues, chromosomal translocations, thyroid abnormalities, or inherited bleeding disorders and guide further treatment.
Report
Share
Report
Share
Recommended
RPL.pptx
This document discusses investigations and management of recurrent pregnancy loss (RPL). It notes that RPL affects 1-3% of couples trying to conceive and that only about 26% of RPL patients receive an explained diagnosis. Recommended initial investigations for all RPL patients include screening for hereditary thrombophilia, pelvic ultrasound, thyroid antibodies, and parental karyotyping. Chromosomal abnormalities are a common cause of early pregnancy loss. Management involves treating any identified causes, lifestyle modifications, and psychological support. Progesterone supplementation may help reduce further losses in unexplained cases. Most RPL patients will achieve a live birth in their next pregnancy despite not receiving an explained diagnosis.
Recurrent preg loss
This document discusses recurrent pregnancy loss (RPL), defined as 3 or more losses prior to 20 weeks. It provides background on incidence and risk factors for RPL. Etiologies of RPL include genetic, anatomic, immunologic, endocrine, inherited thrombophilias, infectious, and unexplained factors. Investigations of couples with RPL may include screening for antiphospholipid antibodies, cytogenetic analysis, karyotyping, pelvic ultrasound, and screening for inherited thrombophilias. Treatment options depend on etiology and may include aspirin and heparin for antiphospholipid syndrome, referral for genetic factors, surgery for anatomical factors, progesterone supplementation, and supportive care for unexplained RPL.
Rpl.nka
1) Recurrent miscarriage is defined as 3 or more consecutive pregnancy losses at or before 20 weeks gestation. It affects approximately 1% of fertile couples.
2) The main causes of recurrent pregnancy loss are parental chromosomal abnormalities, uterine abnormalities, and antiphospholipid antibody syndrome. Other potential causes include endocrine, immunological, thrombophilic, and infectious factors.
3) Evaluation of patients with recurrent miscarriage includes obtaining a thorough history, physical exam, testing for antiphospholipid antibodies and parental chromosome analysis, and evaluating the uterine cavity through procedures like hysterosalpingogram or hysteroscopy. No cause is identified in around 50% of couples.
Controversy and consensus regarding management of recurrent pregnancy loss.pptx
This document discusses controversy and consensus regarding management of recurrent pregnancy loss. It provides definitions of miscarriage and recurrent pregnancy loss. It examines various potential causes of recurrent pregnancy loss including genetic, immunological, endocrine, anatomical, infectious, and male factors. For each factor, it discusses recommendations for investigation and management based on guidelines from various organizations. The document emphasizes taking a thorough history and investigating multiple potential causes through tests and scans to determine a tailored treatment plan aiming to prevent future miscarriages.
Recurrent pregnancy loss.pptx
This document summarizes information about recurrent pregnancy loss from Dr. Narendra Gupta of Vivekanand Hospital and Fertility Center in Jaipur, India. It defines recurrent pregnancy loss as 3 or more consecutive spontaneous losses and discusses the psychological impact. It outlines the clinical approach, investigations, and etiological factors that should be considered in evaluating recurrent loss. These include anatomical, endocrine, infectious, immune, thrombophilic, genetic, and unexplained causes. Specific diagnostic tests and treatment approaches are described for several of these factors.
Choosing Wisely: 15 Things Physicians and Patients Should Question
This document provides 15 recommendations for clinical practices that should be questioned in obstetrics based on a lack of evidence of benefit or potential for harm. Specifically, it recommends against: performing inherited thrombophilia evaluations; placing cerclages in twin pregnancies; offering noninvasive prenatal testing to low-risk patients; screening for intrauterine growth restriction with Doppler; using progestogens for multifetal gestations; and several other prenatal tests and interventions when scientific evidence is lacking. The recommendations are intended to discourage common practices that have not been shown to meaningfully improve outcomes.
Antithrombotic therapy to prevent recurrent pregnancy loss in.pptx
1) The document discusses antithrombotic therapy for preventing recurrent pregnancy loss in patients with antiphospholipid syndrome.
2) It reviews 11 randomized control trials including over 1600 women comparing treatments like aspirin, low molecular weight heparin (LMWH), and unfractionated heparin.
3) The trials showed that combinations of aspirin and LMWH may increase live birth rates compared to other treatments, but differences were small and results inconclusive due to variability in how treatments were administered between studies.
An update on recurrent pregnancy loss 2015
- Recurrent pregnancy loss is defined as 3 or more consecutive miscarriages before 20 weeks.
- Genetic causes like chromosomal abnormalities are a major cause and account for around 70% of early miscarriages. Karyotyping of pregnancy tissue can identify chromosomal abnormalities.
- Advanced parental age increases the risk of genetic defects leading to miscarriage due to declining egg/sperm quality. Parental karyotyping may identify balanced translocations in 3-5% of couples.
- A thorough evaluation including genetic, endocrine, anatomical, immunological, and infectious factors can identify a cause in 60% of recurrent pregnancy loss cases.
Recommended
RPL.pptx
This document discusses investigations and management of recurrent pregnancy loss (RPL). It notes that RPL affects 1-3% of couples trying to conceive and that only about 26% of RPL patients receive an explained diagnosis. Recommended initial investigations for all RPL patients include screening for hereditary thrombophilia, pelvic ultrasound, thyroid antibodies, and parental karyotyping. Chromosomal abnormalities are a common cause of early pregnancy loss. Management involves treating any identified causes, lifestyle modifications, and psychological support. Progesterone supplementation may help reduce further losses in unexplained cases. Most RPL patients will achieve a live birth in their next pregnancy despite not receiving an explained diagnosis.
Recurrent preg loss
This document discusses recurrent pregnancy loss (RPL), defined as 3 or more losses prior to 20 weeks. It provides background on incidence and risk factors for RPL. Etiologies of RPL include genetic, anatomic, immunologic, endocrine, inherited thrombophilias, infectious, and unexplained factors. Investigations of couples with RPL may include screening for antiphospholipid antibodies, cytogenetic analysis, karyotyping, pelvic ultrasound, and screening for inherited thrombophilias. Treatment options depend on etiology and may include aspirin and heparin for antiphospholipid syndrome, referral for genetic factors, surgery for anatomical factors, progesterone supplementation, and supportive care for unexplained RPL.
Rpl.nka
1) Recurrent miscarriage is defined as 3 or more consecutive pregnancy losses at or before 20 weeks gestation. It affects approximately 1% of fertile couples.
2) The main causes of recurrent pregnancy loss are parental chromosomal abnormalities, uterine abnormalities, and antiphospholipid antibody syndrome. Other potential causes include endocrine, immunological, thrombophilic, and infectious factors.
3) Evaluation of patients with recurrent miscarriage includes obtaining a thorough history, physical exam, testing for antiphospholipid antibodies and parental chromosome analysis, and evaluating the uterine cavity through procedures like hysterosalpingogram or hysteroscopy. No cause is identified in around 50% of couples.
Controversy and consensus regarding management of recurrent pregnancy loss.pptx
This document discusses controversy and consensus regarding management of recurrent pregnancy loss. It provides definitions of miscarriage and recurrent pregnancy loss. It examines various potential causes of recurrent pregnancy loss including genetic, immunological, endocrine, anatomical, infectious, and male factors. For each factor, it discusses recommendations for investigation and management based on guidelines from various organizations. The document emphasizes taking a thorough history and investigating multiple potential causes through tests and scans to determine a tailored treatment plan aiming to prevent future miscarriages.
Recurrent pregnancy loss.pptx
This document summarizes information about recurrent pregnancy loss from Dr. Narendra Gupta of Vivekanand Hospital and Fertility Center in Jaipur, India. It defines recurrent pregnancy loss as 3 or more consecutive spontaneous losses and discusses the psychological impact. It outlines the clinical approach, investigations, and etiological factors that should be considered in evaluating recurrent loss. These include anatomical, endocrine, infectious, immune, thrombophilic, genetic, and unexplained causes. Specific diagnostic tests and treatment approaches are described for several of these factors.
Choosing Wisely: 15 Things Physicians and Patients Should Question
This document provides 15 recommendations for clinical practices that should be questioned in obstetrics based on a lack of evidence of benefit or potential for harm. Specifically, it recommends against: performing inherited thrombophilia evaluations; placing cerclages in twin pregnancies; offering noninvasive prenatal testing to low-risk patients; screening for intrauterine growth restriction with Doppler; using progestogens for multifetal gestations; and several other prenatal tests and interventions when scientific evidence is lacking. The recommendations are intended to discourage common practices that have not been shown to meaningfully improve outcomes.
Antithrombotic therapy to prevent recurrent pregnancy loss in.pptx
1) The document discusses antithrombotic therapy for preventing recurrent pregnancy loss in patients with antiphospholipid syndrome.
2) It reviews 11 randomized control trials including over 1600 women comparing treatments like aspirin, low molecular weight heparin (LMWH), and unfractionated heparin.
3) The trials showed that combinations of aspirin and LMWH may increase live birth rates compared to other treatments, but differences were small and results inconclusive due to variability in how treatments were administered between studies.
An update on recurrent pregnancy loss 2015
- Recurrent pregnancy loss is defined as 3 or more consecutive miscarriages before 20 weeks.
- Genetic causes like chromosomal abnormalities are a major cause and account for around 70% of early miscarriages. Karyotyping of pregnancy tissue can identify chromosomal abnormalities.
- Advanced parental age increases the risk of genetic defects leading to miscarriage due to declining egg/sperm quality. Parental karyotyping may identify balanced translocations in 3-5% of couples.
- A thorough evaluation including genetic, endocrine, anatomical, immunological, and infectious factors can identify a cause in 60% of recurrent pregnancy loss cases.
Threatened and unexplained repeated miscarriages
1. The document discusses threatened and unexplained recurrent miscarriages. It provides information on the definition, incidence, types, causes, prognosis, and management of threatened and recurrent miscarriages.
2. For threatened miscarriages, the use of progestins is the most promising treatment and can significantly reduce the rate of miscarriage compared to placebo. For unexplained recurrent miscarriages, the prognosis is generally good without intervention, as many cases are due to chromosomal abnormalities rather than underlying maternal issues.
3. Basic investigations should be performed to investigate potential causes of recurrent miscarriage such as anatomical abnormalities, endocrine disorders, infections, thrombophilias, and alloimmune factors. However, for most cases
Interesting Update on Recurrent Miscarriage for Indian Gynaecologoists D...
OUTLINE….of RM
* KNOWN KNOWN What we know & we DO: **KNOWN UNKNOWN What we know but do not do: ***UNKNOWN KNOWN What we know that we do not know ****UNKNOWN UNKNOWN TOTALLY NEW .. Future
ESHRE Guideline on Recurrent Pregnancy Loss (RPL)
Dr Sujoy Dasgupta invited to deliver a lecture on "RPL- ESHRE Guideline" in the Annual Conference of RCOG (Royal College of Obstetricians and Gynaecologists) IRC (International Representative Committee) India East held on 20-21 May, 2023
screening for down syndrome
Prenatal screening and diagnosis allows for the detection of fetal abnormalities before birth. It involves various screening techniques in the first and second trimester such as nuchal translucency measurement, maternal serum markers, and ultrasound exams. Invasive diagnostic tests such as amniocentesis and chorionic villus sampling allow for the analysis of fetal cells to check for genetic abnormalities. The goal of prenatal screening and diagnosis is to provide information to parents about the health of the fetus and allow for informed decision making and management planning.
Recurrent miscarriage: how to manage
it is really frustrating to women and challenging to doctors when they face repeated loss of pregnancy what is called recurrent abortion: how to manage such problem?? this talk may help in answering this question
Bad obstetric history
This document discusses evaluating and managing bad obstetric history (BOH). BOH refers to previous disappointments in childbearing like miscarriages, stillbirths, preterm births, or other complications. A detailed history and medical record review aims to identify recurrent or non-recurrent causes. Common causes include pre-eclampsia, inherited or acquired thrombophilia, parental genetic disorders, anatomical factors, endocrine issues, and infections. Investigation may include screening tests for these conditions. Management focuses on modifying identified risks in the current pregnancy through treatments like low-dose aspirin for pre-eclampsia risk and close monitoring throughout pregnancy. The goal is to learn from past pregnancies to optimize outcomes in future pregnancies.
Recurrent miscarriage ppt gynae seminar
This document discusses recurrent miscarriage, providing definitions and epidemiology. It defines recurrent miscarriage as 3 or more consecutive miscarriages. Causes discussed include polycystic ovary syndrome, antiphospholipid syndrome, chromosomal abnormalities, endocrine disorders, and uterine abnormalities. Investigation and management strategies are presented for different potential causes. For unexplained recurrent miscarriage, progesterone and aspirin are discussed but evidence for their effectiveness is limited. Counseling and lifestyle modifications are recommended.
The 10 recommendations of society of maternal fetal medicine 2016
The document outlines 10 recommendations from the Society for Maternal-Fetal Medicine (SMFM) on practices that should not be performed during pregnancy. The recommendations advise against routine serologic screening, inherited thrombophilia evaluation, Doppler screening for IUGR, noninvasive prenatal testing for low-risk patients, redundant aneuploidy screening, cervical length screening outside certain gestational ages, cerclage for twin pregnancies, progestogen use for multifetal gestations, activity restriction, and antenatal testing without indications in diet-controlled gestational diabetes.
Abnormal Uterine Bleeding1107 Holm
This document summarizes abnormal uterine bleeding, including its definitions, etiologies, evaluation, and management. It discusses how abnormal uterine bleeding can be caused by systemic, reproductive tract, or dysfunctional issues. Evaluation may involve tests and procedures to determine the cause. Management options include progestins, estrogen, oral contraceptives, NSAIDs, antifibrinolytics, and surgery. Progestins are often the preferred first-line treatment for abnormal uterine bleeding of anovulatory origin.
Recurrent pregnancy loss 1
1) Recurrent pregnancy loss is defined as three or more consecutive pregnancy losses before 20 weeks of gestation. A thorough investigation should be conducted to identify potentially treatable causes.
2) Common etiological factors include uterine anomalies, immunological issues such as antiphospholipid syndrome, endocrine disorders such as thyroid disease or diabetes, genetic factors, and thrombophilic disorders.
3) Evaluation involves a detailed history, physical exam, ultrasound, hormonal and immunological testing. Uterine anomalies require hysteroscopy or laparoscopy. Treatment depends on the underlying cause but may include surgery, medication, lifestyle changes, or cerclage. The goal is to identify modifiable risk factors.
Antiphospholipid antibody syndrome
This document summarizes the antiphospholipid antibody syndrome (APS). It discusses that APS is characterized by the presence of antiphospholipid antibodies (aPLs) along with clinical manifestations such as vascular thrombosis or pregnancy morbidity. The diagnostic criteria for APS requires at least one clinical feature and one laboratory feature present on two or more occasions at least 12 weeks apart. Common obstetric complications of APS include recurrent miscarriage, fetal loss, severe preeclampsia before 34 weeks gestation, and severe placental insufficiency. The pathogenesis of APS is thought to involve thrombosis, defective placentation, and local inflammatory events.
Recurrent pregnancy loss panel discussion
This document discusses recurrent pregnancy loss and provides information on definitions, incidence, causes, investigations, and guidelines. Some key points:
- Recurrent pregnancy loss is defined as 3 or more clinically recognized pregnancy losses before 20 weeks. The incidence is about 1 in 300 pregnancies.
- Common causes include genetic factors in the parents or embryo, anatomic abnormalities, endocrine/immune/infectious factors, and inherited thrombophilias.
- Investigations should include parental karyotyping after 2 losses, and karyotyping of pregnancy tissues is recommended by RCOG guidelines to provide counseling and predict outcomes of future pregnancies.
- Biomarkers and ultrasound can provide information on predicting outcomes,
Recurrent pregnancy loss: interactive session
This document discusses evaluation and management of recurrent pregnancy loss (RPL). It provides questions and answers on various topics:
- RPL is defined as 2 or more pregnancy losses. Ectopic pregnancies are not included. Most RPL (75%) occurs in the first trimester.
- Risk factors for RPL include increased maternal age over 40, obesity, smoking, caffeine intake over 500mg/day, and alcohol consumption.
- Evaluation involves assessing anatomical, endocrine, thrombophilic, immunological and genetic factors. Screening for inherited thrombophilia is not recommended.
- Treatment depends on identified causes. For uterine abnormalities, metroplasty may be considered for bicornuate uterus
unexplained recurrent pregnancy loss case scenario
This patient has a history of 6 miscarriages between 8-9 weeks of pregnancy. Testing showed normal hormone levels, thyroid function, parental karyotypes, and other factors. The patient was treated with various medications for subsequent pregnancies with one live birth. For the seventh pregnancy, the patient underwent paternal leukocyte immunization and developed antibodies, resulting in an uneventful pregnancy and live birth. The eighth pregnancy is currently ongoing.
Fetal growth restriction:Evidence based management 2018
DGF CME on 29th January 2018
Evidence based management of fetal growth restriction latest update
MANAGING APLA - AN EVIDENCE BASED PRACTICAL APPROACH BY DR SHASHWAT JANI
This document discusses the diagnosis and management of antiphospholipid syndrome (APS), also known as Hughes syndrome. APS is an autoimmune disorder characterized by blood clots or pregnancy complications in patients who test positive for antiphospholipid antibodies. The document provides details on diagnostic criteria, treatment recommendations including low-dose aspirin and heparin during pregnancy, and antenatal surveillance for successful fetal outcomes in APS patients.
Recurrent Pregnancy Loss
Recurrent pregnancy loss is defined as three or more consecutive pregnancy losses before 20 weeks of gestation. The document discusses the types, causes, risk factors, diagnosis, and management of recurrent pregnancy loss. It notes that chromosomal abnormalities account for 30-57% of recurrent losses. Thrombophilias and autoimmune factors like antiphospholipid syndrome may also play a role. Evaluation includes testing for genetic and anatomical abnormalities, as well as endocrine, immune, and coagulation disorders. Progesterone supplementation and low-dose aspirin are beneficial for some cases of unexplained recurrent pregnancy loss.
1. recurrent pregnancy loss
This document discusses recurrent pregnancy loss. It defines recurrent miscarriage as three or more consecutive spontaneous abortions before 20 weeks of gestation. Evaluation and treatment should focus on common and treatable causes like uterine anomalies, endocrine abnormalities, autoimmune disorders, thrombophilia, and genetic factors. Management may include surgical correction of septate uterus, treatment of thyroid disorders, anticoagulation for antiphospholipid syndrome, and assisted reproductive technology for translocations. Unexplained recurrent loss can be managed with lifestyle changes, progesterone, low-dose aspirin, and close monitoring during subsequent pregnancies.
Ivf in pcos
This document discusses IVF treatment for polycystic ovary syndrome (PCOS). It begins with an overview of PCOS prevalence, definitions, and diagnostic criteria. IVF is indicated for PCOS patients who fail to conceive after ovulation induction or have other fertility factors. Patient preparation, gonadotropin protocols and monitoring, triggering ovulation, embryo transfer, and luteal phase support are discussed. Outcomes are better with GnRH antagonist protocols for PCOS patients due to lower gonadotropin doses and risk of ovarian hyperstimulation syndrome (OHSS). Primary and secondary prevention of OHSS includes metformin use, coasting, cryopreservation of embryos, and GnRH agonist triggering of ovulation.
Recurrent pregnancy loss: causes and diagnosis, myths and facts (evidence based)
The document discusses recurrent pregnancy loss (RPL) and provides information on various potential causes. It begins by defining RPL as the loss of three or more clinically recognized pregnancies before 24 weeks of gestation. The incidence of RPL is approximately 10-15% of recognized pregnancies under 20 weeks. Extensive evaluation is not generally recommended after a single miscarriage. Potential causes discussed include epidemiological factors, antiphospholipid syndrome, anatomical abnormalities, genetic and endocrine issues, immune factors, infections, and thrombophilia. Evaluation and management depends on factors like maternal age, previous history, and clinical findings.
CA STOMACH.pptx
This document summarizes the etiology, pathology, modes of spread, and clinical features of carcinoma of the stomach. It discusses that carcinoma of the stomach is more common in males and in Japan. The etiology includes factors like family history, smoking, diet high in nitrosamines, H. pylori infection, and Menetrier's disease. Pathologically, carcinomas are classified based on gross appearance, Lauren's classification of intestinal vs diffuse type, depth of invasion, and WHO histological type. Modes of spread are direct, via lymphatics, blood, and peritoneum. Clinical features include lump, anemia, gastric outlet obstruction, and atypical presentations like Sister Mary Joseph nodule or
fibroadenoma.pptx
Fibroadenoma is a benign breast tumor composed of both glandular and stromal tissue. It commonly occurs in young women between ages 15-25. While fibroadenomas are noncancerous and do not spread, some may increase in size over time. Diagnosis is usually made through mammography, ultrasound, or biopsy. Treatment options include surgical excision or observation with regular ultrasound screening, depending on the size and characteristics of the tumor.
More Related Content
Similar to recurrent pregnancy loss.pptx
Threatened and unexplained repeated miscarriages
1. The document discusses threatened and unexplained recurrent miscarriages. It provides information on the definition, incidence, types, causes, prognosis, and management of threatened and recurrent miscarriages.
2. For threatened miscarriages, the use of progestins is the most promising treatment and can significantly reduce the rate of miscarriage compared to placebo. For unexplained recurrent miscarriages, the prognosis is generally good without intervention, as many cases are due to chromosomal abnormalities rather than underlying maternal issues.
3. Basic investigations should be performed to investigate potential causes of recurrent miscarriage such as anatomical abnormalities, endocrine disorders, infections, thrombophilias, and alloimmune factors. However, for most cases
Interesting Update on Recurrent Miscarriage for Indian Gynaecologoists D...
OUTLINE….of RM
* KNOWN KNOWN What we know & we DO: **KNOWN UNKNOWN What we know but do not do: ***UNKNOWN KNOWN What we know that we do not know ****UNKNOWN UNKNOWN TOTALLY NEW .. Future
ESHRE Guideline on Recurrent Pregnancy Loss (RPL)
Dr Sujoy Dasgupta invited to deliver a lecture on "RPL- ESHRE Guideline" in the Annual Conference of RCOG (Royal College of Obstetricians and Gynaecologists) IRC (International Representative Committee) India East held on 20-21 May, 2023
screening for down syndrome
Prenatal screening and diagnosis allows for the detection of fetal abnormalities before birth. It involves various screening techniques in the first and second trimester such as nuchal translucency measurement, maternal serum markers, and ultrasound exams. Invasive diagnostic tests such as amniocentesis and chorionic villus sampling allow for the analysis of fetal cells to check for genetic abnormalities. The goal of prenatal screening and diagnosis is to provide information to parents about the health of the fetus and allow for informed decision making and management planning.
Recurrent miscarriage: how to manage
it is really frustrating to women and challenging to doctors when they face repeated loss of pregnancy what is called recurrent abortion: how to manage such problem?? this talk may help in answering this question
Bad obstetric history
This document discusses evaluating and managing bad obstetric history (BOH). BOH refers to previous disappointments in childbearing like miscarriages, stillbirths, preterm births, or other complications. A detailed history and medical record review aims to identify recurrent or non-recurrent causes. Common causes include pre-eclampsia, inherited or acquired thrombophilia, parental genetic disorders, anatomical factors, endocrine issues, and infections. Investigation may include screening tests for these conditions. Management focuses on modifying identified risks in the current pregnancy through treatments like low-dose aspirin for pre-eclampsia risk and close monitoring throughout pregnancy. The goal is to learn from past pregnancies to optimize outcomes in future pregnancies.
Recurrent miscarriage ppt gynae seminar
This document discusses recurrent miscarriage, providing definitions and epidemiology. It defines recurrent miscarriage as 3 or more consecutive miscarriages. Causes discussed include polycystic ovary syndrome, antiphospholipid syndrome, chromosomal abnormalities, endocrine disorders, and uterine abnormalities. Investigation and management strategies are presented for different potential causes. For unexplained recurrent miscarriage, progesterone and aspirin are discussed but evidence for their effectiveness is limited. Counseling and lifestyle modifications are recommended.
The 10 recommendations of society of maternal fetal medicine 2016
The document outlines 10 recommendations from the Society for Maternal-Fetal Medicine (SMFM) on practices that should not be performed during pregnancy. The recommendations advise against routine serologic screening, inherited thrombophilia evaluation, Doppler screening for IUGR, noninvasive prenatal testing for low-risk patients, redundant aneuploidy screening, cervical length screening outside certain gestational ages, cerclage for twin pregnancies, progestogen use for multifetal gestations, activity restriction, and antenatal testing without indications in diet-controlled gestational diabetes.
Abnormal Uterine Bleeding1107 Holm
This document summarizes abnormal uterine bleeding, including its definitions, etiologies, evaluation, and management. It discusses how abnormal uterine bleeding can be caused by systemic, reproductive tract, or dysfunctional issues. Evaluation may involve tests and procedures to determine the cause. Management options include progestins, estrogen, oral contraceptives, NSAIDs, antifibrinolytics, and surgery. Progestins are often the preferred first-line treatment for abnormal uterine bleeding of anovulatory origin.
Recurrent pregnancy loss 1
1) Recurrent pregnancy loss is defined as three or more consecutive pregnancy losses before 20 weeks of gestation. A thorough investigation should be conducted to identify potentially treatable causes.
2) Common etiological factors include uterine anomalies, immunological issues such as antiphospholipid syndrome, endocrine disorders such as thyroid disease or diabetes, genetic factors, and thrombophilic disorders.
3) Evaluation involves a detailed history, physical exam, ultrasound, hormonal and immunological testing. Uterine anomalies require hysteroscopy or laparoscopy. Treatment depends on the underlying cause but may include surgery, medication, lifestyle changes, or cerclage. The goal is to identify modifiable risk factors.
Antiphospholipid antibody syndrome
This document summarizes the antiphospholipid antibody syndrome (APS). It discusses that APS is characterized by the presence of antiphospholipid antibodies (aPLs) along with clinical manifestations such as vascular thrombosis or pregnancy morbidity. The diagnostic criteria for APS requires at least one clinical feature and one laboratory feature present on two or more occasions at least 12 weeks apart. Common obstetric complications of APS include recurrent miscarriage, fetal loss, severe preeclampsia before 34 weeks gestation, and severe placental insufficiency. The pathogenesis of APS is thought to involve thrombosis, defective placentation, and local inflammatory events.
Recurrent pregnancy loss panel discussion
This document discusses recurrent pregnancy loss and provides information on definitions, incidence, causes, investigations, and guidelines. Some key points:
- Recurrent pregnancy loss is defined as 3 or more clinically recognized pregnancy losses before 20 weeks. The incidence is about 1 in 300 pregnancies.
- Common causes include genetic factors in the parents or embryo, anatomic abnormalities, endocrine/immune/infectious factors, and inherited thrombophilias.
- Investigations should include parental karyotyping after 2 losses, and karyotyping of pregnancy tissues is recommended by RCOG guidelines to provide counseling and predict outcomes of future pregnancies.
- Biomarkers and ultrasound can provide information on predicting outcomes,
Recurrent pregnancy loss: interactive session
This document discusses evaluation and management of recurrent pregnancy loss (RPL). It provides questions and answers on various topics:
- RPL is defined as 2 or more pregnancy losses. Ectopic pregnancies are not included. Most RPL (75%) occurs in the first trimester.
- Risk factors for RPL include increased maternal age over 40, obesity, smoking, caffeine intake over 500mg/day, and alcohol consumption.
- Evaluation involves assessing anatomical, endocrine, thrombophilic, immunological and genetic factors. Screening for inherited thrombophilia is not recommended.
- Treatment depends on identified causes. For uterine abnormalities, metroplasty may be considered for bicornuate uterus
unexplained recurrent pregnancy loss case scenario
This patient has a history of 6 miscarriages between 8-9 weeks of pregnancy. Testing showed normal hormone levels, thyroid function, parental karyotypes, and other factors. The patient was treated with various medications for subsequent pregnancies with one live birth. For the seventh pregnancy, the patient underwent paternal leukocyte immunization and developed antibodies, resulting in an uneventful pregnancy and live birth. The eighth pregnancy is currently ongoing.
Fetal growth restriction:Evidence based management 2018
DGF CME on 29th January 2018
Evidence based management of fetal growth restriction latest update
MANAGING APLA - AN EVIDENCE BASED PRACTICAL APPROACH BY DR SHASHWAT JANI
This document discusses the diagnosis and management of antiphospholipid syndrome (APS), also known as Hughes syndrome. APS is an autoimmune disorder characterized by blood clots or pregnancy complications in patients who test positive for antiphospholipid antibodies. The document provides details on diagnostic criteria, treatment recommendations including low-dose aspirin and heparin during pregnancy, and antenatal surveillance for successful fetal outcomes in APS patients.
Recurrent Pregnancy Loss
Recurrent pregnancy loss is defined as three or more consecutive pregnancy losses before 20 weeks of gestation. The document discusses the types, causes, risk factors, diagnosis, and management of recurrent pregnancy loss. It notes that chromosomal abnormalities account for 30-57% of recurrent losses. Thrombophilias and autoimmune factors like antiphospholipid syndrome may also play a role. Evaluation includes testing for genetic and anatomical abnormalities, as well as endocrine, immune, and coagulation disorders. Progesterone supplementation and low-dose aspirin are beneficial for some cases of unexplained recurrent pregnancy loss.
1. recurrent pregnancy loss
This document discusses recurrent pregnancy loss. It defines recurrent miscarriage as three or more consecutive spontaneous abortions before 20 weeks of gestation. Evaluation and treatment should focus on common and treatable causes like uterine anomalies, endocrine abnormalities, autoimmune disorders, thrombophilia, and genetic factors. Management may include surgical correction of septate uterus, treatment of thyroid disorders, anticoagulation for antiphospholipid syndrome, and assisted reproductive technology for translocations. Unexplained recurrent loss can be managed with lifestyle changes, progesterone, low-dose aspirin, and close monitoring during subsequent pregnancies.
Ivf in pcos
This document discusses IVF treatment for polycystic ovary syndrome (PCOS). It begins with an overview of PCOS prevalence, definitions, and diagnostic criteria. IVF is indicated for PCOS patients who fail to conceive after ovulation induction or have other fertility factors. Patient preparation, gonadotropin protocols and monitoring, triggering ovulation, embryo transfer, and luteal phase support are discussed. Outcomes are better with GnRH antagonist protocols for PCOS patients due to lower gonadotropin doses and risk of ovarian hyperstimulation syndrome (OHSS). Primary and secondary prevention of OHSS includes metformin use, coasting, cryopreservation of embryos, and GnRH agonist triggering of ovulation.
Recurrent pregnancy loss: causes and diagnosis, myths and facts (evidence based)
The document discusses recurrent pregnancy loss (RPL) and provides information on various potential causes. It begins by defining RPL as the loss of three or more clinically recognized pregnancies before 24 weeks of gestation. The incidence of RPL is approximately 10-15% of recognized pregnancies under 20 weeks. Extensive evaluation is not generally recommended after a single miscarriage. Potential causes discussed include epidemiological factors, antiphospholipid syndrome, anatomical abnormalities, genetic and endocrine issues, immune factors, infections, and thrombophilia. Evaluation and management depends on factors like maternal age, previous history, and clinical findings.
Similar to recurrent pregnancy loss.pptx (20)
Interesting Update on Recurrent Miscarriage for Indian Gynaecologoists D...
Interesting Update on Recurrent Miscarriage for Indian Gynaecologoists D...
The 10 recommendations of society of maternal fetal medicine 2016
The 10 recommendations of society of maternal fetal medicine 2016
unexplained recurrent pregnancy loss case scenario
unexplained recurrent pregnancy loss case scenario
Fetal growth restriction:Evidence based management 2018
Fetal growth restriction:Evidence based management 2018
MANAGING APLA - AN EVIDENCE BASED PRACTICAL APPROACH BY DR SHASHWAT JANI
MANAGING APLA - AN EVIDENCE BASED PRACTICAL APPROACH BY DR SHASHWAT JANI
Recurrent pregnancy loss: causes and diagnosis, myths and facts (evidence based)
Recurrent pregnancy loss: causes and diagnosis, myths and facts (evidence based)
More from 04AdithyaSuresh
CA STOMACH.pptx
This document summarizes the etiology, pathology, modes of spread, and clinical features of carcinoma of the stomach. It discusses that carcinoma of the stomach is more common in males and in Japan. The etiology includes factors like family history, smoking, diet high in nitrosamines, H. pylori infection, and Menetrier's disease. Pathologically, carcinomas are classified based on gross appearance, Lauren's classification of intestinal vs diffuse type, depth of invasion, and WHO histological type. Modes of spread are direct, via lymphatics, blood, and peritoneum. Clinical features include lump, anemia, gastric outlet obstruction, and atypical presentations like Sister Mary Joseph nodule or
fibroadenoma.pptx
Fibroadenoma is a benign breast tumor composed of both glandular and stromal tissue. It commonly occurs in young women between ages 15-25. While fibroadenomas are noncancerous and do not spread, some may increase in size over time. Diagnosis is usually made through mammography, ultrasound, or biopsy. Treatment options include surgical excision or observation with regular ultrasound screening, depending on the size and characteristics of the tumor.
family planning.pptx
This document summarizes key aspects of demography and family welfare programs in India. It discusses that demography is the study of human populations, focusing on population size, composition, and distribution. India has a large population of over 139 crore people. The family welfare program aims to control population growth and reduce mortality rates through family planning initiatives like contraception and sterilization. The Reproductive and Child Health program and National Health Mission work to improve maternal, newborn, and child health indicators in India.
ORGANOPHOSPHATE POISONING.pptx
Organophosphate poisoning is caused by chemicals that inhibit the enzyme acetylcholinesterase. These chemicals are commonly used as agricultural pesticides and have worldwide mortality rates of 3-25% depending on dosage and treatment. Organophosphates work by binding irreversibly to acetylcholinesterase through their central phosphorus atom. Symptoms usually begin within minutes to hours of exposure through various routes of absorption. Management involves atropine administration to counteract muscarinic effects and oximes to reactivate acetylcholinesterase.
CHRONIC PANCREATITIS.pptx
Chronic pancreatitis is a progressive inflammatory disease of the pancreas characterized by irreversible destruction of pancreatic tissue. It most commonly affects males around age 40. The main causes are high alcohol consumption in 60-70% of cases and pancreatic duct obstruction. Patients present with persistent abdominal pain that radiates to the back. Investigations include CT scan, MRCP, and endoscopic ultrasound to identify complications like pseudocysts and ductal strictures. Treatment involves pain management, pancreatic enzyme supplementation, and potentially endoscopic or surgical interventions like drainage procedures if complications develop.
MANAGEMENT OF RECTAL CARCINOMA.pptx
1. Surgery is the main treatment for rectal carcinoma, with total mesorectal excision being the standard surgical approach. The main surgeries are abdominoperineal resection for low tumors and anterior resection for mid and upper tumors.
2. Preoperative radiotherapy with or without chemotherapy can downstage the cancer and reduce local recurrence. Adjuvant chemotherapy improves survival for node-positive cancers.
3. Other treatments include transanal total mesorectal excision, palliative procedures like Hartmann's operation, and chemotherapy and immunotherapy for metastatic disease. Prognosis depends on stage and tumor characteristics, with 5-year survival rates ranging from 90% for stage I to 5% for stage IV
Management Of Epithelial Ovarian Cancer.pptx
Management of epithelial ovarian cancer depends on FIGO stage. For early stages (I-II), management includes hysterectomy and bilateral salpingo-oophorectomy, followed by chemotherapy except for stage IA-B. For advanced stages (III-IV), management involves debulking surgery followed by chemotherapy. The standard chemotherapy is paclitaxel and carboplatin given intravenously every 3 weeks for 6 cycles. Prognosis depends on stage, with 5-year survival rates ranging from over 90% for stage IA to under 30% for stage IV disease.
benign prostatic hyperplasia and carcinoma.pptx
Benign prostatic hyperplasia (BPH) is a common condition in aging men characterized by the non-cancerous growth of the prostate gland. The prostate enlarges and can squeeze the urethra and obstruct the flow of urine. BPH typically presents with symptoms like frequent urination, weak urine stream, and inability to empty the bladder fully. Diagnosis involves a digital rectal exam and tests like uroflowmetry. Treatment options include medications to reduce prostate size or relieve symptoms, minimally invasive procedures, and surgery if medications do not help or for severe cases.
vaginitis.pptx
Vaginitis refers to inflammation of the vaginal wall that is commonly caused by infections. The three most common types of vaginitis are trichomoniasis, candidiasis, and bacterial vaginosis. Trichomoniasis causes a foul-smelling greenish discharge and is caused by the protozoan Trichomonas vaginalis. Candidiasis results in a curdy white discharge due to the fungus Candida albicans. Bacterial vaginosis involves a shift in vaginal flora leading to a gray white discharge with a fishy odor.
TOXOIDS.pptx
Toxoids are vaccines created from bacterial toxins that have been inactivated through chemical or heat treatment. This process removes the toxins' ability to cause disease but maintains their ability to provoke an immune response. To make a toxoid vaccine, the toxin is first isolated from the pathogen's culture and then inactivated using formaldehyde and heat. This inactivated toxin can then trigger antibody production without causing illness. Common commercially available toxoids include those protecting against tetanus, diphtheria, and pertussis. Different combinations of these toxoids in vaccines like Tdap, DTaP, Td, and DT provide protection against the corresponding diseases at different stages of life.
More from 04AdithyaSuresh (10)
Recently uploaded
Travel Clinic Cardiff: Health Advice for International Travelers
Travel Clinic Cardiff offers comprehensive travel health services, including vaccinations, travel advice, and preventive care for international travelers. Our expert team ensures you are well-prepared and protected for your journey, providing personalized consultations tailored to your destination. Conveniently located in Cardiff, we help you travel with confidence and peace of mind. Visit us: www.nxhealthcare.co.uk
Post-Menstrual Smell- When to Suspect Vaginitis.pptx
Do you have abnormal smell after periods? It may be vaginitis. Do not worry, herbal medicine Fuyan Pill can help you get a cure.
Artificial Intelligence Symposium (THAIS)
Artificial Intelligence Symposium (THAIS). Parc Taulí. Sabadell
June 2024 Oncology Cartoons By Dr Kanhu Charan Patro
une 2024 Oncology Cartoons By Dr Kanhu Charan Patro
CLEAR ALIGNER THERAPY IN ORTHODONTICS .pptx
Dr. ZANAB FARHEEN FAYAZ ,MDS(ORTHODONTICS & DENTOFACIAL ORTHOPEDICS ).
How to choose the best dermatologists in Indore.
The skin is the largest organ and its health plays a vital role among the other sense organs. The skin concerns like acne breakout, psoriasis, or anything similar along the lines, finding a qualified and experienced dermatologist becomes paramount.
Top Travel Vaccinations in Manchester
Travel vaccination in Manchester offers comprehensive immunization services for individuals planning international trips. Expert healthcare providers administer vaccines tailored to your destination, ensuring you stay protected against various diseases. Conveniently located clinics and flexible appointment options make it easy to get the necessary shots before your journey. Stay healthy and travel with confidence by getting vaccinated in Manchester. Visit us: www.nxhealthcare.co.uk
10 Benefits an EPCR Software should Bring to EMS Organizations
The benefits of an ePCR solution should extend to the whole EMS organization, not just certain groups of people or certain departments. It should provide more than just a form for entering and a database for storing information. It should also include a workflow of how information is communicated, used and stored across the entire organization.
Acute Gout Care & Urate Lowering Therapy .pdf
In this document , the management of acute gout attacks and a description of urate lowering therapy is mentioned.
REGULATION FOR COMBINATION PRODUCTS AND MEDICAL DEVICES.pptx
It includes regulation of combination products and medical devices. FDA and industry liaisons.
Ketone bodies and metabolism-biochemistry
This slide consists of all the topics of ketone . This can be used for exam purpose for writing about Diabetic keto acidosis etc . Thank you
MERCURY GROUP.BHMS.MATERIA MEDICA.HOMOEOPATHY
Mercurius is named after the roman god mercurius, the god of trade and science. The planet mercurius is named after the same god. Mercurius is sometimes called hydrargyrum, means ‘watery silver’. Its shine and colour are very similar to silver, but mercury is a fluid at room temperatures. The name quick silver is a translation of hydrargyrum, where the word quick describes its tendency to scatter away in all directions.
The droplets have a tendency to conglomerate to one big mass, but on being shaken they fall apart into countless little droplets again. It is used to ignite explosives, like mercury fulminate, the explosive character is one of its general themes.
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptx
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.Cosmetology and Trichology Courses at Kosmoderma Academy PRP (Hair), DR Growt...
Cosmetology and Trichology Courses at Kosmoderma Academy PRP (Hair), DR Growt...Kosmoderma Academy Of Aesthetic Medicine
Kosmoderma Academy, a leading institution in the field of dermatology and aesthetics, offers comprehensive courses in cosmetology and trichology. Our specialized courses on PRP (Hair), DR+Growth Factor, GFC, and Qr678 are designed to equip practitioners with advanced skills and knowledge to excel in hair restoration and growth treatments.
share - Lions, tigers, AI and health misinformation, oh my!.pptx
• Pitfalls and pivots needed to use AI effectively in public health
• Evidence-based strategies to address health misinformation effectively
• Building trust with communities online and offline
• Equipping health professionals to address questions, concerns and health misinformation
• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
Recently uploaded (20)
CHEMOTHERAPY_RDP_CHAPTER 6_Anti Malarial Drugs.pdf
CHEMOTHERAPY_RDP_CHAPTER 6_Anti Malarial Drugs.pdf
Travel Clinic Cardiff: Health Advice for International Travelers
Travel Clinic Cardiff: Health Advice for International Travelers
Post-Menstrual Smell- When to Suspect Vaginitis.pptx
Post-Menstrual Smell- When to Suspect Vaginitis.pptx
June 2024 Oncology Cartoons By Dr Kanhu Charan Patro
June 2024 Oncology Cartoons By Dr Kanhu Charan Patro
Ear and its clinical correlations By Dr. Rabia Inam Gandapore.pptx
Ear and its clinical correlations By Dr. Rabia Inam Gandapore.pptx
10 Benefits an EPCR Software should Bring to EMS Organizations
10 Benefits an EPCR Software should Bring to EMS Organizations
REGULATION FOR COMBINATION PRODUCTS AND MEDICAL DEVICES.pptx
REGULATION FOR COMBINATION PRODUCTS AND MEDICAL DEVICES.pptx
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptx
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptx
Cosmetology and Trichology Courses at Kosmoderma Academy PRP (Hair), DR Growt...
Cosmetology and Trichology Courses at Kosmoderma Academy PRP (Hair), DR Growt...
share - Lions, tigers, AI and health misinformation, oh my!.pptx
share - Lions, tigers, AI and health misinformation, oh my!.pptx
recurrent pregnancy loss.pptx
- 1. Recurrent Pregnancy Loss - Investigations Presented By : Adithya S , MBBS Govt Thiruvarur Medical College
- 2. Introduction The term recurrent pregnancy loss is used when miscarriage occurs consecutively in three or more pregnancies, prior to the 20th week of pregnancy. The underlying causes of recurrent pregnancy loss can be due to increased maternal age, uterine anomalies, and other genetic and maternal factors.
- 3. Investigations The main recommended investigations for recurrent pregnancy loss are: 1. Anti phospholipid antibody assay 2. Hysterosalpingography /Sonohysterography 3. Karyotyping (parental and foetal) 4. Thyroid profile 5. Glucose profile 6. Thrombophilia
- 4. It is recommended that all women with recurrent first trimester miscarriage and all women with one or more second trimester miscarriages should be screened before pregnancy for the presence of antiphospholipid antibodies. Testing for APA syndrome The following anti bodies have established assays : • Anticardiolipin antibody • Lupus anticoagulant • Anti-β-2 glycoprotein 1 • Antiphospholipid antibodies Antiphospholipid syndrome is confirmed when the woman has two positive tests at least 12 weeks apart for either lupus anticoagulant or anticardiolipin antibodies.
- 5. Anatomic causes of RPL like structural uterine abnormalities and congenital uterine malformations are typically diagnosed using hysterosalpingography (HSG) and sonohysterography. Hysterosalpingography & Sonohysterography Hysteroscopy, 3D ultrasound, or magnetic resonance imaging (MRI) may also be useful in defining the abnormality but are more expensive modalities.
- 6. KARYOTYPING PARENTAL KARYOTYPING • Karyotyping of both partners has been found to be helpful in predicting future RPL. • Chromosomal abnormalities implicated in RPL are balanced reciprocal or Robertsonian translocation in one partner. KARYOTYPING OF THE ABORTUS • If the abortus is found to be aneuploid, then a maternal cause can be excluded.
- 7. THYROID & GLUCOSE PROFILE An increased risk of RPL is associated with subclinical hypothyroidism and presence of thyroid peroxidase antibodies. Routine testing for diabetes is recommended only if the symptoms or clinical findings warrant testing.
- 8. THROMBOPHILIAS Screening for inherited thrombophilia is not recommended as their role in recurrent early pregnancy loss is uncertain. Deficiencies of Antithrombin , Protein C and Protein S indicate thrombophilia. There is no evidence that antithrombotic therapy for this reason effectively prevents miscarriage.
Editor's Notes
- Sonohysterography is a technique in which saline is injected through the cervix into the uterus, and an ultrasound image is obtained of the uterine cavity. The fluid reveals more detail of the uterine cavity than when ultrasound is used alone.