Evaluation and Management of Women who Have Experienced Stillbirth in Their Previous Pregnancies
Objective: To evaluate the subsequent pregnancy outcomes of women who have experienced unexplained stillbirth in their previous gestations. Study Design: This retrospective cohort consisted of 14 pregnancies who had stillbirth (without known risk factors) in their previous pregnancies. These patie...
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Medical Network
2021-04-01
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| Series: | Gynecology Obstetrics & Reproductive Medicine |
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| Online Access: | https://gorm.com.tr/index.php/GORM/article/view/892 |
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| author | Erdem Fadiloglu Atakan Tanacan Canan Unal Mehmet Sinan Beksac |
| author_facet | Erdem Fadiloglu Atakan Tanacan Canan Unal Mehmet Sinan Beksac |
| author_sort | Erdem Fadiloglu |
| collection | DOAJ |
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Objective: To evaluate the subsequent pregnancy outcomes of women who have experienced unexplained stillbirth in their previous gestations.
Study Design: This retrospective cohort consisted of 14 pregnancies who had stillbirth (without known risk factors) in their previous pregnancies. These patients had been included in a special preconceptional care program to be evaluated in terms of etiological risk factors for stillbirth. At least one of the risk factors, such as methylenetetrahydrofolate reductase (MTHFR) polymorphisms, hereditary thrombophilias and autoimmune problems, were defined in this study population. After detection of pregnancy, the patients were administered low-dose low-molecular-weight heparin (LMWH) (enoxaparin, 1×2000 Anti-XA IU/0.2 mL/day), low-dose salicylic acid (100 mg/day) and low-dose corticosteroid (methylprednisolone, 1×4 mg/day orally) in necessary cases.
Results: Out of 14 pregnancies, 4 (28.5%) ended up with miscarriages at 9, 11, 11 and 15 gestational weeks, respectively. The remaining 10 pregnancies ended up with alive deliveries. The mean gestational week at birth was 36.4±0.51, while the mean birthweight was 2882±381.01 g. Out of 10 pregnancies, only one was diagnosed as IUGR. Only two newborn necessitated hospitalization in the neonatal intensive care unit (NICU) due to respiratory problems. Both newborns were discharged from the NICU without any further complication at the post-partum 5th day.
Conclusion: Patients with a prior stillbirth should be screened for MTHFR polymorphisms, autoimmune problems and hereditary thrombophilias, especially in case of absence of any etiological factor. Management of these patients with low-dose aspirin, low-dose low molecular weight heparin and corticosteroids seemed to be beneficial for increasing live birth rates and avoiding obstetric complications.
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| format | Article |
| id | doaj-art-58698bf57ea24c39a10c841eeb751c90 |
| institution | Kabale University |
| issn | 1300-4751 2602-4918 |
| language | English |
| publishDate | 2021-04-01 |
| publisher | Medical Network |
| record_format | Article |
| series | Gynecology Obstetrics & Reproductive Medicine |
| spelling | doaj-art-58698bf57ea24c39a10c841eeb751c902025-02-11T21:11:53ZengMedical NetworkGynecology Obstetrics & Reproductive Medicine1300-47512602-49182021-04-0127110.21613/GORM.2018.892Evaluation and Management of Women who Have Experienced Stillbirth in Their Previous PregnanciesErdem Fadiloglu0Atakan Tanacan1Canan Unal2Mehmet Sinan Beksac3Hacettepe University Department of Gynecology and Obstetrics Perinatology DivisionHacettepe University Department of Gynecology and Obstetrics Perinatology DivisionHacettepe University Department of Gynecology and Obstetrics Perinatology DivisionHacettepe University Department of Gynecology and Obstetrics Perinatology Division Objective: To evaluate the subsequent pregnancy outcomes of women who have experienced unexplained stillbirth in their previous gestations. Study Design: This retrospective cohort consisted of 14 pregnancies who had stillbirth (without known risk factors) in their previous pregnancies. These patients had been included in a special preconceptional care program to be evaluated in terms of etiological risk factors for stillbirth. At least one of the risk factors, such as methylenetetrahydrofolate reductase (MTHFR) polymorphisms, hereditary thrombophilias and autoimmune problems, were defined in this study population. After detection of pregnancy, the patients were administered low-dose low-molecular-weight heparin (LMWH) (enoxaparin, 1×2000 Anti-XA IU/0.2 mL/day), low-dose salicylic acid (100 mg/day) and low-dose corticosteroid (methylprednisolone, 1×4 mg/day orally) in necessary cases. Results: Out of 14 pregnancies, 4 (28.5%) ended up with miscarriages at 9, 11, 11 and 15 gestational weeks, respectively. The remaining 10 pregnancies ended up with alive deliveries. The mean gestational week at birth was 36.4±0.51, while the mean birthweight was 2882±381.01 g. Out of 10 pregnancies, only one was diagnosed as IUGR. Only two newborn necessitated hospitalization in the neonatal intensive care unit (NICU) due to respiratory problems. Both newborns were discharged from the NICU without any further complication at the post-partum 5th day. Conclusion: Patients with a prior stillbirth should be screened for MTHFR polymorphisms, autoimmune problems and hereditary thrombophilias, especially in case of absence of any etiological factor. Management of these patients with low-dose aspirin, low-dose low molecular weight heparin and corticosteroids seemed to be beneficial for increasing live birth rates and avoiding obstetric complications. https://gorm.com.tr/index.php/GORM/article/view/892AutoimmunityHereditary thrombophiliaMTHFR polymorphismsPregnancyStillbirth |
| spellingShingle | Erdem Fadiloglu Atakan Tanacan Canan Unal Mehmet Sinan Beksac Evaluation and Management of Women who Have Experienced Stillbirth in Their Previous Pregnancies Gynecology Obstetrics & Reproductive Medicine Autoimmunity Hereditary thrombophilia MTHFR polymorphisms Pregnancy Stillbirth |
| title | Evaluation and Management of Women who Have Experienced Stillbirth in Their Previous Pregnancies |
| title_full | Evaluation and Management of Women who Have Experienced Stillbirth in Their Previous Pregnancies |
| title_fullStr | Evaluation and Management of Women who Have Experienced Stillbirth in Their Previous Pregnancies |
| title_full_unstemmed | Evaluation and Management of Women who Have Experienced Stillbirth in Their Previous Pregnancies |
| title_short | Evaluation and Management of Women who Have Experienced Stillbirth in Their Previous Pregnancies |
| title_sort | evaluation and management of women who have experienced stillbirth in their previous pregnancies |
| topic | Autoimmunity Hereditary thrombophilia MTHFR polymorphisms Pregnancy Stillbirth |
| url | https://gorm.com.tr/index.php/GORM/article/view/892 |
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