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Recurrent Pregnancy Loss

Recurrent Pregnancy Loss

Ole Bjarne Christiansen (Editor)

ISBN: 978-1-118-74918-0 November 2013 Wiley-Blackwell 208 Pages




Recurrent Pregnancy Loss

Edited by

Ole B Christiansen, MD, D.M.Sc., Rigshospitalet, Copenhagen and AalborgUniversityHospital, Aalborg, Denmark

Recurrent Pregnancy Loss is a silent problem for many women

The spontaneous loss of a pregnancy in the first 22 weeks is often not recorded as the mother needed no medical or surgical treatment. Women who repeatedly suffer this tragedy can go unheard as a result. Gynecologists can feel unable to help.

But they can help. Research is showing how to identify women who suffer recurrent pregnancy loss and which treatments might prevent a further recurrence. Gynecologists are learning how to monitor subsequent pregnancies for the early signals of problems.

Recurrent Pregnancy Loss provides a practical approach to this hidden clinical challenge. The highly experienced, international author team explores:

  • How to obtain a relevant history
  • Which investigations to order
  • The physiological reasons behind recurrent pregnancy loss
  • The best approach to treatment
  • How to monitor patients in subsequent pregnancies

Clinical in approach, practical in execution, with the patient at the centre, Recurrent Pregnancy Loss guides you as you support your patients.

Series Foreword vii

Contributors viii

Preface to the first edition xii

1 Obtaining the Relevant History 1
Ole B. Christiansen

2 Which Investigations Are Relevant? 10
Paulien G. de Jong, Emmy van den Boogaard, Claudia R. Kowalik, Rosa Vissenberg, Saskia Middeldorp and Mariëtte Goddijn

3 NK Cells in Peripheral Blood and the Endometrium 29
Gavin Sacks

4 Cytokines and Cytokine Gene Polymorphisms in Recurrent Pregnancy Loss 38
Silvia Daher, Maria Regina Torloni and Rosiane Mattar

5 How to Assess the Prognosis after Recurrent Miscarriage 46
Howard J.A. Carp

6 Which Treatments Should be Offered? PGD/PGS, Allogeneic Lymphocyte Immunization, Intravenous Immunoglobulin 61
Henriette Svarre Nielsen and Ole B. Christiansen

7 Which Treatment Should be Offered? Heparin/Aspirin, Progesterone, Prednisolone 70
Muhammad A. Akhtar and Siobhan Quenby

8 Which Treatment Should be Offered: Metformin, hCG, GM-CSF/G-CSF, TNF-α Inhibitors, Standard IVF/ICSI 78
Ole B. Christiansen

9 Talking to Patients about Lifestyle, Behavior, and Miscarriage Risk 86
Ruth Bender Atik and Barbara E. Hepworth-Jones

10 E ndocrine and Ultrasonic Surveillance of Pregnancies in Patients with Recurrent Miscarriage 103
Adjoa Appiah and Jemma Johns

11 Obstetric Complications in Patients with Recurrent Miscarriage – How Should they be Monitored
in the Third Trimester? 115
Shehnaaz Jivraj

12 Recurrent Miscarriage after ART: A Double Challenge 128
Elisabeth C. Larsen and Ole B. Christiansen

13 How to Cope with Stress and Depression in Women with Recurrent Miscarriage 135
Keren Shakhar and Dida Fleisig

14 Recurrent Miscarriage and the Risk of Autoimmune Disease and Thromboembolic Disease 146
M. Angeles Martínez-Zamora, Ricard Cervera and Juan Balasch

15 How to Organize and Run an Early Pregnancy Unit/Recurrent Miscarriage Clinic 157
AnnMaria Ellard and Roy G. Farquharson

16 How to Organize an Early Pregnancy Unit/Recurrent Miscarriage Clinic – American Perspective 172
Joanne Kwak-Kim, Kuniaki Ota and Ae-Ra Han

17 Case Studies 180
Ole B. Christiansen

Index 191