Etiological Factors for First Single Early Pregnancy Loss: Are They Different from Recurrent Pregnancy Loss?
Papa Dasari, Sonal Garg, Rakhee Kar, Thyagaraju Chitra
Endocrine cause, Etiology, First early pregnancy loss, Miscarriage, Recurrent pregnancy loss, Thrombophilia
Citation Information :
Dasari P, Garg S, Kar R, Chitra T. Etiological Factors for First Single Early Pregnancy Loss: Are They Different from Recurrent Pregnancy Loss?. J South Asian Feder Obs Gynae 2021; 13 (4):259-264.
Aim and objective: The recommendation for investigation of pregnancy loss is to test only after two or more pregnancy losses. But in practice, we find women with single pregnancy loss seeking explanation. The purpose of this study was to determine the identifiable causes and their proportion in women with first early pregnancy loss and to compare with that of women with recurrent pregnancy loss (RPL).Materials and methods: This cross-sectional analytical study was undertaken between 2018 and 2019. Group A included 105 women with first single pregnancy loss and group B included 105 women with RPL. The recommended investigations for etiological factors were done in both groups except karyotyping, and thrombophilia screening was done in those with unknown etiology.
Statistical analysis: Etiological factors were expressed as proportions, and comparison between two groups was done by unpaired t-test and Mann–Whitney test.
Results: Sociodemographic factors and gestational age were similar in both the groups. Significantly more number of women with first single pregnancy loss (58%) had known etiological factors than women with RPL (43%) (p = 0.038). Endocrine causes were commonest in both the groups (first pregnancy loss 36% vs RPL 21%; p = 0.023). Out of the women with unknown causes, 18% of women were positive for thrombophilia in each group and more than 50% of them were antiphospholipid antibodies (APLA) positive.
Conclusion: Significant proportion of women with single first pregnancy loss have treatable etiological factors like those of RPL. Hence evaluation should be undertaken to achieve optimum outcomes during the next pregnancy and prevent RPL.
Clinical significance: Evaluation of women with first pregnancy loss helps the clinician to prevent pregnancy loss in subsequent pregnancies by appropriate management as per the etiology.
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