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Outcome of Index Pregnancy in Women with Recurrent Pregnancy Loss (RPL)

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Abstract

Background

Recurrent pregnancy loss (RPL) is encountered in 2–5% of Obstetric population and in 50% the cause is unknown and hence it is a challenging situation for the Obstetrician to manage such women. This study was undertaken with the objectives of finding out the causes of RPL, comparing the outcome of index pregnancy between unknown RPL and known RPL and to study the pregnancy outcome with thromboprophylaxis in women with unknown RPL.

Methods

Prospective observational study involving 323 women was undertaken in a tertiary care Institute South India. Women with two or more pregnancy losses without any live birth were included after ethical clearance and were investigated including thrombophilia screening. SSPS version 20 was used for statistical analysis. Comparison of pregnancy outcomes was determined with binomial test of proportions and pregnancy outcome in unknown RPL was calculated by Fisher’s exact test or Chi-square test.

Results

The common etiological factors were Thrombophilias (33%), followed by endocrine causes. There was no difference in miscarriage rates and live birth rates but IUGR, Stillbirth and perinatal deaths were significantly more in women with known RPL after interventions. In unknown RPL thromboprophylaxis with combination of aspirin, enoxaparin or progesterone resulted in significantly more term birth rates (93%).

Conclusion

Thrombophilias were found to be the most common cause in this cohort of Indian women. In women with unknown RPL, thromboprophylaxis with Aspirin alone results in high incidence of preterm birth. Aspirin combined with Enoxaparin and or Progesterone achieves high live birth rate of term foetuses.

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There is no funding from any source for the study.

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Authors and Affiliations

  1. Department of OBGY, JIPMER, Pondicherry, 06, India

    Paapa Dasari

  2. Department of OBGY, KMCH-IHSR, Coimbatore, India

    G. Suganya

Authors
  1. Paapa Dasari
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  2. G. Suganya
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Correspondence to Paapa Dasari.

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Ethical statement

The Research involved Human participants and ethical approval was obtained from the Institute and informed consent was taken from the Subjects of the study. The manuscript is solely submitted to the Journal of Obstetrics and Gynaecology of India. The work is original and not published elsewhere and not split in to any parts and submitted elsewhere. Oral presentation was done in World congress FIGO- Rio. Data was processed and results as per the standards and there is no fabrication of results. The study was approved the Institute Ethics committee and was performed in line with the principles of the Declaration of Helsinki. Human Studies (IEC/SC/2012/4/152. Consent was obtained from all the subjects who participated in the study.

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Paapa Dasari is the Professor, Department of OBGY, JIPMER, Pondicherry-06; Suganya G is the Assistant Professor, Department of OBGY, KMCH-IHSR, Coimbatore.

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Dasari, P., Suganya, G. Outcome of Index Pregnancy in Women with Recurrent Pregnancy Loss (RPL). J Obstet Gynecol India 72 (Suppl 1), 152–158 (2022). https://doi.org/10.1007/s13224-021-01598-4

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  • DOI: https://doi.org/10.1007/s13224-021-01598-4

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