PREDICTION OF SPONTANEOUS ABORTION IN TI-lE FIRST TRIMESTER

Abstract

Spontaneous abortion or early pregnancy failure is one of the most frequent complications of pregnancy, but great difficulty is still experienced in reliably anticipating which pregnancies will terminate in abortion and in many cases a definitive diagnosis is only made when the cervix is found to be opemng. This situation is particularily distressing to those patients with a history of threatened or recurrent abortion who abort despite resting in hospital for many weeks. There is, therefore, a need for techniques which will allow an early diagnosis to be made in these patients, preferably with such certainty that a more active line of management can be pursued if so desired (Hugh, 1975).

Anticipation of fetal death in utero or impending abortion of a live fetus proved to be a much more difficult problem, and in only those patients who aborted a live fetus before the tenth week of pregnancy did the sonar examination revealed any significant abnormality (Hugh, 1975):

Few clinical situations frustrate, both, patients and their physician, as much as recurrent pregnancy loss, to the extent that the most we can offer are emotional support and accurate counseling concerning recurrence risks. Only in this way, we can help couples with recurrent pregnancy loss, make the difficult but obligatory decisions they are faced with regarding their reproductive options (Ecker et al, 1993).

When afflicted with repetitive pregnancy loss, couples want to know the chances for another loss and what they should do to ensure a successful pregnancy (Hatasaka, 1994). It is estimated that 16% to 25% of all women will experience vaginal bleeding in early pregnancy, frequently giving rise to considerable anxiety, spontaneous abortion may ensure in as many as 50% of cases and it is often difficult to give appropriate reassurance to the women (Tom and Philip, 1996).