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Recurrent Miscarriage
Recurrent miscarriage or recurrent pregnancy loss (RPL) is the spontaneous loss of 2-3 pregnancies that is estimated to affect up to 5% of women. The exact number of pregnancy losses and gestational weeks used to define RPL differs among medical societies. In the majority of cases, the exact cause of pregnancy loss is unexplained despite genetic testing and a thorough evaluation. When a cause for RPL is identified, almost half are attributed to a chromosomal abnormality (ie. aneuploidy). RPL has been associated with several risk factors including parental and genetic factors (ie. advanced maternal age, chromosomal abnormalities, sperm DNA fragmentation), congenital and acquired anatomical conditions, lifestyle factors (ie. cigarette smoking, caffeine, alcohol, stress), endocrine disorders, thrombophila (clotting disorders), immunological factors, and infections. The American Society of Reproductive Medicine recommends a thorough evaluation after 2 consecutive pregnancy losses ...
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Obstetrics
Obstetrics is the field of study concentrated on pregnancy, childbirth and the postpartum period. As a medical specialty, obstetrics is combined with gynecology under the discipline known as obstetrics and gynecology (OB/GYN), which is a surgical field. Main areas Prenatal care Prenatal care is important in screening for various complications of pregnancy. This includes routine office visits with physical exams and routine lab tests along with telehealth care for women with low-risk pregnancies: Image:Ultrasound_image_of_a_fetus.jpg, 3D ultrasound of fetus (about 14 weeks gestational age) Image:Sucking his thumb and waving.jpg, Fetus at 17 weeks Image:3dultrasound 20 weeks.jpg, Fetus at 20 weeks First trimester Routine tests in the first trimester of pregnancy generally include: * Complete blood count * Blood type ** Rh-negative antenatal patients should receive RhoGAM at 28 weeks to prevent Rh disease. * Indirect Coombs test (AGT) to assess risk of hem ...
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Thrombophilia
Thrombophilia (sometimes called hypercoagulability or a prothrombotic state) is an abnormality of blood coagulation that increases the risk of thrombosis (blood clots in blood vessels). Such abnormalities can be identified in 50% of people who have an episode of thrombosis (such as deep vein thrombosis in the leg) that was not provoked by other causes. A significant proportion of the population has a detectable thrombophilic abnormality, but most of these develop thrombosis only in the presence of an additional risk factor. There is no specific treatment for most thrombophilias, but recurrent episodes of thrombosis may be an indication for long-term preventive anticoagulant, anticoagulation. The first major form of thrombophilia to be identified by medical science, antithrombin deficiency, was identified in 1965, while the most common abnormalities (including factor V Leiden) were described in the 1990s. Signs and symptoms The most common conditions associated with thrombophi ...
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Hysterosalpingography
Hysterosalpingography (HSG), also known as uterosalpingography, is a radiology, radiologic procedure to investigate the shape of the uterine cavity and the shape and patency of the fallopian tubes. It is a special x-ray procedure using Contrast agent, dye to look at the womb (uterus) and fallopian tubes. In this procedure, a radio-opaque material is injected into the cervix, cervical canal, and radiographs are taken. A normal result shows the filling of the uterine cavity and the bilateral filling of the fallopian tube with the injection material. To demonstrate tubal patency, spillage of the material into the peritoneal cavity needs to be observed. Hysterosalpingography has vital role in treatment of infertility, especially in the case of fallopian tube blockage. Uses HSG is considered a Diagnosis, diagnostic procedure. It is used in the workup of infertile females to assess the patency of fallopian tubes, assess the competency of the cervix or congenital abnormality of the ute ...
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Arcuate Uterus
The arcuate uterus is a form of a uterine anomaly or variation where the uterine cavity displays a concave contour towards the fundus. Normally the uterine cavity is straight or convex towards the fundus on anterior-posterior imaging, but in the arcuate uterus the myometrium of the fundus dips into the cavity and may form a small septation. The distinction between an arcuate uterus and a septate uterus is not standardized. Signs and symptoms The condition may not be known to the affected individual and not result in any reproductive problems; thus normal pregnancies occur. Indeed, there is no consensus on the relationship of the arcuate uterus and recurrent pregnancy loss. Accordingly, the condition may be a variation or a pathology. One view maintains that the condition is associated with a higher risk for miscarriage, premature birth, and malpresentation. Thus a study that evaluated women with uterine bleeding by hysteroscopy found that 6.5% of subjects displayed the arcuat ...
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Uterus Didelphys
Uterus didelphys (; sometimes also ''uterus '') represents a uterine malformation where the uterus is present as a paired organ when the embryogenetic fusion of the Müllerian ducts fails to occur. As a result, there is a double uterus with two separate cervices, and possibly a double vagina as well. Each uterus has a single horn linked to the ipsilateral fallopian tube that faces its ovary. Most non-human mammals have a non-single uterus with separation of horns. Marsupials and rodents have a double uterus ( uterus duplex). In other animals (''e.g.'' nematodes), the term 'didelphic' refers to a double genital tract, as opposed to monodelphic, with a single tract. Signs and symptoms Those with the condition may be asymptomatic and unaware of having a double uterus. However, a study by Heinonen showed that certain conditions are more common. In his study of 26 women with a double uterus gynecological complaints included dysmenorrhea and dyspareunia. All patients displayed a do ...
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Bicornuate Uterus
A bicornuate uterus or bicornate uterus (from the Latin ''cornū'', meaning "horn"), is a type of müllerian anomalies, Müllerian anomaly in the human uterus, where there is a deep indentation at the Uterus#Structure, fundus (top) of the uterus. Pathophysiology A bicornuate uterus develops during embryogenesis. It occurs when the proximal (upper) portions of the paramesonephric ducts do not fuse, but the distal portions that develops into the lower uterine segment, cervix, and upper vagina fuse normally. Diagnosis Diagnosis of bicornuate uterus typically involves imaging of the uterus with 2D or 3D Gynecologic ultrasonography, ultrasound, hysterosalpingography, or magnetic resonance imaging (MRI). On imaging, a bicornuate uterus can be distinguished from a septate uterus by the angle between the cornua (intercornual angle): less than 75 degrees in a septate uterus, and greater than 105 degrees in a bicornuate uterus. Measuring the depth of the cleft between the cornua (fundal ...
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Septate Uterus
A uterine septum is a congenital uterine malformation where the uterine cavity is partitioned by a longitudinal septum; the outside of the uterus has a normal typical shape. The wedge-like partition may involve only the superior part of the cavity resulting in an ''incomplete septum'' or a ''subseptate uterus'', or less frequently the total length of the cavity (''complete septum'') and the cervix resulting in a double cervix. The septation may also continue caudally into the vagina resulting in a " double vagina". Signs and symptoms The condition may not be known to the affected individual and not result in any reproductive problems; thus normal pregnancies may occur. In more serious cases have reported high infertility rates. However, it is associated with a higher risk for miscarriage, premature birth, and malpresentation. According to the classical study by Buttram there is a 60% risk of a spontaneous abortion, this being more common in the second than in the first trimeste ...
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Unicornuate Uterus
A unicornuate uterus represents a uterine malformation where the uterus is formed from only one of the paired Müllerian ducts while the other Müllerian duct does not develop or only in a rudimentary fashion. The sometimes called hemi-uterus has a single horn linked to the ipsilateral fallopian tube that faces its ovary. Signs and symptoms Women with the condition may be asymptomatic and unaware of having a unicornuate uterus; normal pregnancy may occur. In a review of the literature Reichman et al. analyzed the data on pregnancy outcome of 290 women with a unicornuate uterus. 175 women had conceived for a total of 468 pregnancies. They found that about 50% of patients delivered a live baby. The rates for ectopic pregnancy was 2.7%, for miscarriage 34%, and for preterm delivery 20%, while the intrauterine demise rate was 10%. Thus patients with a unicornuate uterus are at a higher risk for pregnancy loss and obstetrical complications. Cause The uterus is normally formed durin ...
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Uterus
The uterus (from Latin ''uterus'', : uteri or uteruses) or womb () is the hollow organ, organ in the reproductive system of most female mammals, including humans, that accommodates the embryonic development, embryonic and prenatal development, fetal development of one or more Fertilized egg, fertilized eggs until birth. The uterus is a hormone-responsive sex organ that contains uterine gland, glands in its endometrium, lining that secrete uterine milk for embryonic nourishment. (The term ''uterus'' is also applied to analogous structures in some non-mammalian animals.) In humans, the lower end of the uterus is a narrow part known as the Uterine isthmus, isthmus that connects to the cervix, the anterior gateway leading to the vagina. The upper end, the body of the uterus, is connected to the fallopian tubes at the uterine horns; the rounded part, the fundus, is above the openings to the fallopian tubes. The connection of the uterine cavity with a fallopian tube is called the utero ...
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Products Of Conception
Products of conception, abbreviated POC, is a medical term used for the tissue derived from the union of an Egg (biology), egg and a sperm. It encompasses anembryonic gestation (blighted ovum) which does not have a viable embryo. In the context of tissue from a dilation and curettage, the presence of POC essentially excludes an ectopic pregnancy. Retained products of conception ''Retained products of conception'' is where products of conception remain in the uterus after childbirth, medical abortion or miscarriage (also known as spontaneous abortion). Miscarriage with retained products of conception is termed ''delayed'' when no or very little products of conception have been passed, and ''incomplete'' when some products have been passed but some still remain ''Uterus, in utero''. Diagnosis The diagnosis is based on clinical presentation, quantitative Human chorionic gonadotropin, HCG, ultrasound, and pathologic evaluation. A solid, heterogeneous, echogenic mass has a positive p ...
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Robertsonian Translocation
Robertsonian translocation (ROB) is a Chromosome abnormality, chromosomal abnormality where the entire long arms of two different chromosome, chromosomes become fused to each other. It is the most common form of chromosomal translocation in humans, affecting 1 out of every 1,000 babies born. It does not usually cause medical problems, though some people may produce Gamete, gametes with an incorrect number of chromosomes, resulting in a risk of miscarriage. In rare cases this Chromosomal translocation, translocation results in Down syndrome and Patau syndrome. Robertsonian translocations result in a reduction in the number of chromosomes. A Robertsonian evolutionary fusion, which may have occurred in the common ancestor of humans and other great apes, is the reason humans have 46 chromosomes while all other primates have 48. Detailed DNA studies of chimpanzee, orangutan, gorilla and bonobo apes has determined that where human chromosome 2 is present in our DNA in all four great ape ...
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Fluorescence In Situ Hybridization
Fluorescence ''in situ'' hybridization (FISH) is a molecular cytogenetic technique that uses fluorescent probes that bind to only particular parts of a nucleic acid sequence with a high degree of sequence complementarity. It was developed by biomedical researchers in the early 1980s to detect and localize the presence or absence of specific DNA sequences on chromosomes. Fluorescence microscopy can be used to find out where the fluorescent probe is bound to the chromosomes. FISH is often used for finding specific features in DNA for use in genetic counseling, medicine, and species identification. FISH can also be used to detect and localize specific RNA targets (mRNA, lncRNA and miRNA) in cells, circulating tumor cells, and tissue samples. In this context, it can help define the spatial-temporal patterns of gene expression within cells and tissues. Probes – RNA and DNA In biology, a probe is a single strand of DNA or RNA that is complementary to a nucleotide sequence of ...
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