Recurrent abortion in 1st trimester, investigation of choice:
Correct Answer: Karyotyping
Description: Hence karyotyping of the both partners is recommended in recurrent miscarriage. Prenatal diagnosis is usually advised in the next pregnancy.
As discussed earlier, infections be it HIV / TORCH are not a cause of recurrent abortion.
Because TORCH infections are not a cause of recurrent abortions:
TORCH profile should not be included in the set of investigations done to find out the cause of recurrent abortion
Investigative measures useful in the evaluation of recurrent early pregnancy loss:
Novak 14/e, p 1302; Leon Speroff, 1090
Parental peripheral blood karyotypingQ with banding technique.
Assessment of the intrauterine cavity with either office hysteroscopy or hysterosalpingography.
Thyroid function tests, serum prolactin levels if indicated.
Anticardiolipin antibody and lupus anticoagulant testing (aPTT or Russell Viper venom testing).
Complete blood counts with platelet count.
Thrombophilia testing:
– Factor V leiden, prothrombin gene mutation, Protein S activity.
– Serum homocysteine level.
– In the presence of a family or personal history of venous thromboembolism, protein C and antithrombin activity.
The American college of obstetricians and Gynaecology recognizes only 2 types of tests as having clear value in the investigation of recurrent miscarriages:
Parental cytogenetic analysis
Lupus anticoagulant and anticardiolipin antibodies assay.
Williams Obs 23/e, p 241
Category:
Gynaecology & Obstetrics
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