Friday, 15 March 2019

Investigations of Recurrent Early Pregnancy loss -How best to minimize cost of investigations??


  History: - What about her nutrition, any F/H/O of Koch’s? Explore family tree for genetic diseases, Life style disease /habit of either partner.
 Low cost initial tests if not done elsewhere:-Caution: Not to Rpt Lab tests except possibly ICT, APL, and gene disorders.  Koch’s:-Common Tests”- In addition suggestions made by some forum members, may carry out Complete haemogram, Thalassaemia screening, Viral screening, Metabolic screen (HBA1C & PPBS)  & endocrine screen( TSH, PRL, Total testosterone) Thrombophilias Screening, AMH-an indirect way of assessing quality of oocyte, both partner Karyotyping, APLA, Tests for SLE ,Urine RE C/S, H semen analysis & Bacteriological screening of semen  Pap.

Uncommon Tests: - AMA, ANA. Hystero-Laparoscopy-Minimal endometriosis & septal diseases of uterus.
Psycho-immunology in the treatment of RSA is an emerging subject. Support of the family members & relatives/ friends .But in the days of consumers many doctors are hesitant to assure the couple “All is well, Next time such unfortunate event will not occur. I am with you. God is going to bless you this time.”

Summary:-Above all, uterine malformations, endocrine disorders and advanced age of any one partner are the usual causes of  may read RCOG green top guideline no. 17 (issued on April, 2011). In about 50% cases the etiology remains unexplored. But in such situation, I do prescribe, albeit imperially a course of antibiotics for pelvic . Infection like doxycycline & Azithromycin.





No comments:

Post a Comment