Pre pregnancy investigation in a case who had one intra uterine foetal demise list thereof

Routine;

A)     BLOOD:-    1)  Complete Haemogram, 2) ABO, Rh Type, 3) Oral GTTT, 4)Hepatitis Serology,5)HIV I & II, 6)TPHA, 7)Thyroid profile including  Anti-TPO Ab,  Thyroid Binding Protein, Thyroid peroxidase antibody, anti-thyroglobulin antibody and anti-microsomal antibody,8) serum creatinine(N-0.5-1mg/dL).9) HbA1c 10) Thalassaemia Screening_,

B)   URINE:  1) Routine Midstream Clean catch urine for culture & sensitivity Test. 2) Urine for microalbuminuria (N=012-0.15mg/dL i.e. <0.2mg/dL. 3) protein/creatinine ratio. (

C)    Special Investigations.

A)     Blood:-  Tests for maternal acquired thrombophilia Screening; e.g. 1) Anticardiolopin ab. ACL ab. IgG & IgM –- (Expressed in  GPL U/ml.--APTT .2) Lupus anticoagulant ab LAC --expressed as  dRVVT,  3) β-glycoprotein ab , APTT, KCT, 4) Thrombin time, 5)  Prothrombin Time, 6)  Activated Partial Thromboplastin Time, B) Tests for Acquired Thrombophilia;-) 2) Expressed in  GPL U/ml & 3) β2 Glycoprotein antibodies’

b) Tests for auto-antibodies e.g. ANA, anti-double stranded DNA, Anti-mitochondrial antibodies. Anti smooth muscle Ab., Anti Neutrophil cytoplasmic antibody (ANCA).2) uric Acid (N-2.5-6.5mg/dL). Chlamydial antibody.

B)     Urine: - 1) Urinary Creatinine (N -30-140 mg), 14-22mg/Kg./Day.

2) Albumin/Creatinine Ratio (ACR) = <0.03mg   ==normal less than 30.  = N< 30mcg of creatinine / per mg. of creatinine.-

D) Karyotyping of both partners.

E)  3-D Pelvic USG –Submucus Myoma/PCOS. D) MRI –genital Tract abnormalities.

F) Further Special Blood Tests: - Hereditary Thrombophilia. Congenital Thrombophilia. Genetic Thrombophilia.

Protein C Deficiency.
Protein S Deficiency.
Factor V Leiden Mutation.
Prothrombin Gene Mutation