Risk Factors for Spontaneous Abortion

A case-control study was conducted to evaluate risk factors for spontaneous abortions. Cases were 94 women with two or more unexplained miscarriages (after exclusion of genetic, endocrine and Müllerian factors) and no term pregnancy, controls were 176 women admitted for normal delivery to the same clinic where cases were identified. Questions were asked about personal characteristics and habits, and gynaecological history. A family history of recurrent miscarriage was more common among women with spontaneous miscarriages than among the controls (13 cases versus 8 controls, relative risk (RR) =3.2, 95% confidence interval (CI) = 1.3-8.1). Compared to women whose menarche occurred at age 11 or younger, the RRs were 0.8 when menarche occurred at age 12-13 and 0.5 at age 14 or more: this trend in risk was statistically significant. Compared with never smokers, current smokers had about a 40% increased risk of miscarriage and the risk increased with number of cigarettes per day. No association emerged with socio-demographic characteristics (e.g. education, marital status, age of the partner), reproductive history (age at first pregnancy), type of contraceptive used and other general lifestyle habits (e.g. alcohol or coffee consumption

Risk Factors for Spontaneous Abortion

A case-control study was conducted to evaluate risk factors for spontaneous abortions. Cases were 94 women with two or more unexplained miscarriages (after exclusion of genetic, endocrine and M\ufcllerian factors) and no term pregnancy, controls were 176 women admitted for normal delivery to the same clinic where cases were identified. Questions were asked about personal characteristics and habits, and gynaecological history. A family history of recurrent miscarriage was more common among women with spontaneous miscarriages than among the controls (13 cases versus 8 controls, relative risk (RR) = 3.2, 95% confidence interval (CI) = 1.3-8.1). Compared to women whose menarche occurred at age 11 or younger, the RRs were 0.8 when menarche occurred at age 12-13 and 0.5 at age 14 or more: this trend in risk was statistically significant. Compared with never smokers, current smokers had about a 40% increased risk of miscarriage and the risk increased with number of cigarettes per day. No association emerged with sociodemographic characteristics (e.g. education, marital status, age of the partner), reproductive history (age at first pregnancy), type of contraceptive used and other general lifestyle habits (e.g. alcohol or coffee consumption)

Prenatal manifestation and management of a mother and child affected by spondyloperipheral dysplasia with a C-propeptide mutation in COL2A1: case report

It is not unusual for patients with "rare" conditions, such as skeletal dysplasias, to remain undiagnosed until adulthood. In such cases, a pregnancy may unexpectedly reveal hidden problems and special needs. A 28 year old primigravida was referred to us at 17 weeks for counselling with an undiagnosed skeletal dysplasia with specific skeletal anomalies suggesting the collagen 2 disorder, spondyloperipheral dysplasia (SPD; MIM 156550)

Progestogens for Maintenance Tocolysis in Women With a Short Cervix: A Randomized Controlled Trial

To assess the efficacy of progestogens for maintenance tocolysis in women undelivered after their first preterm labor episode

Anti-phospholipid antibody mediated fetal loss: still an open question from a pathogenic point of view

Antiphospholipid antibodies (aPL) are associated with recurrent miscarriages and pregnancy complications, however their pathogenic mechanisms are still matter of research. Thrombotic events at the placental level cannot explain all of the clinical manifestations. It has been suggested that aPL may be responsible for a local acute inflammatory response mediated by complement activation and neutrophil infiltration eventually leading to fetal loss. However histological and immunohistological studies on human placental samples do support such a mechanism only in part and with no any clear relationship with the pregnancy outcome. A direct effect of aPL on both maternal and fetal placental tissues has been reported through the reactivity of the antibodies with beta2 glycoprotein I (beta2GPI) expressed on the cell membranes. These events do not require an inflammatory response and can be in part related to the inhibition of growth factors favouring a physiological placentation. Understanding the different pathogenic mechanisms of aPL-associated miscarriages may help in improving our therapeutic approach particularly in recurrent cases not responsive to the usual treatment

Weekly epirubicin in the treatment of gestational breast cancer (GBC)

International audienceGBC is a rare disease and chemotherapy in this setting lacks a standardized approach. Patients 16–30 weeks pregnant with locally advanced/metastatic disease or with high risk of recurrence after surgery were evaluated. Twenty patients received weekly epirubicin 35 mg/m. Median maternal age was 37 years (23–42). Median gestational age at chemotherapy was 19 weeks. Thirteen patients were treated after surgery while 7 had locally advanced tumours of which one had liver metastases. Mean total epirubicin dose was 420 mg/m with a median number of 12 administrations (4–16). No grade 3–4 toxicities were observed. No foetal adverse events were observed except 1 premature delivery at 28 weeks. Births were induced by caesarean section in 12 patients at a median gestational age of 35 weeks. No malformations were reported except 1 newborn with polycystic kidney. At a median age of 2 years, neurological, cardiological and immunological development was normal in all children as reported by their parents. In 7/20 patients with evaluable disease, five had an objective response. At a median follow-up of 38 months, 17 patients are alive; 14 are disease free. Weekly epirubicin appears safe and effective with low foetal toxicity and could be considered in GBC