Robert Brown: Hemostatic Factors in Recurrent Pregnancy Loss
Robert Brown, Academic Obstetrician, shared a post on LinkedIn:
“Recurrent Pregnancy Loss.
Evaluation of recurrent pregnancy loss is indicated after two or three consecutive miscarriages.
The minimum diagnostic work-up consists of a complete medical, surgical, genetic, and family history and a physical examination.
The history should include a description of the gestational age and characteristics of all previous pregnancies.
Physical examination should include a general physical examination with attention to signs of endocrinopathy(hirsutism, galactorrhea) and pelvic organ abnormalities.
Laboratory and imaging tests include: sonohysterogram, testing for antiphospholipid syndrome (ACA antibodies and lupus anticoagulant performed twice twelve weeks apart).
The diagnosis should include anti-beta2glycoprotein I antibodies as well.
TSH and thyroid perixidase antibodies, parental karyotype and karyotype of the abortus if the above examinations are normal.
This is the last test performed only if preceding work-up is yields negative results.
Additional tests depend upon the diagnosis suggested by history, physical examination, and laboratory results.
Male contribution to RPL is unclear.”
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