By Isabel Stabile, J. G. Grudzinskas, T. Chard (auth.), Isabel Stabile PhD, MRCOG, J. G. Grudzinskas MD, FRCOG, FRACOG, T. Chard MD, FRCOG (eds.)
Sixteen British experts pool their large wisdom of spontaneous abortion in a single resource. Their dialogue is at once appropriate to scientific events and is helping establish parts of dialogue and replacement methods.
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Extra info for Spontaneous Abortion: Diagnosis and Treatment
9 No. 10 No. 11 No. 12 No. 13 No. 14 No. 15 No. 16 No. 17 No. 18 No. 19 No. 20 No. 21 No. 0 Pooled data from several series, referenced elsewhere (Simpson and Bombard (1987». found a 77% frequency of chromosomal abnormalities in women studied immediately after ultrasound diagnosis of fetal demise and Ohno et al. 9%. However, Eiben et al. 6%. Tissue for analysis was obtained by chorionic villus sampling, rather than relying later in gestation upon 24 Aetiology of Pregnancy Failure recovery of spontaneously expelled products.
Chromosomal Inversions Another parental chromosomal rearrangement causing fetal loss is an inversion. In this intrachromosomal rearrangement the order of genes is reversed. This rearrangement usually occurs when two chromosomal breaks are followed by reinsertion in reverse order of the chromosomal segment produced by breaks. Inversions in which breakpoints exist on opposite sides of the centromere are pericentric; those in which breakpoints are on the same side of the centromere are paracentric.
Curettage accounts for most cases, with adhesions most likely to develop when the procedure is performed 3 or 4 weeks postpartum. Affected individuals are usually suspected because of menstrual abnormalities, but 15 %-30% of cases become manifested following repeated abortions. If adhesions are detected in a woman experiencing repetitive losses, lysis of the adhesions under direct hysteroscopic visualisation should be performed. Approximately 50% of subjects conceive after surgery, but the frequency of abortions remains high.
Spontaneous Abortion: Diagnosis and Treatment by Isabel Stabile, J. G. Grudzinskas, T. Chard (auth.), Isabel Stabile PhD, MRCOG, J. G. Grudzinskas MD, FRCOG, FRACOG, T. Chard MD, FRCOG (eds.)