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Gynaecology & Obstetrics General 3e10afe5

A lady presented to your with a history of recurent early pregnancy loss. What are the investigation to be ordered:

A
VDRL
B
Toxoplasma serology
C
Hemogram/Blood grouping
D
Rubella screening
High-Yield Explanation
Ans. is C i.e. Hemogram /blood grouping? As discussed in previous answer? Complete blood counts along with platelet count are done in case of recurrent pregnancy loss. VDRL-To test for syphilis Rubella-virus screening are not done because as discussed earlier, infections rarely lead to recurrent Toxoplasma serology pregnancy loss. "Few infection are firmly associated with early pregnancy loss- moreover, if any of these infections are associated with miscarriage, they are even less likely to cause recurrent miscarriage because maternal antibodies usually develop with primary infection. Thus, there appears no concrete indication to screen for infection in asymptomatic women with recurrent miscarriage" "Routine serological lests, cervical cultures and endometrial biopsy to detect genital infections in women with recurrent pregnancy loss cannot be justified. Evaluation should be limited to women with clinical cervicits, chronic or recurrent bacterial vaginosis or other symptoms of pelvic infections" As far as Blood glucose testing is concerned- Neither Novaks, Leon speroff, nor Williams- say that blood glucose levels should be tested in patients with recurrent pregnancy loss - Leon speroff says? " In women with recurrent pregnancy loss, evaluation with blood glucose and HbA,C AIC level is indicated for those with known or suspected diabetes, but otherwise it is unwarranted" So for our exams purposes we have to learn & remember the list of investigations mentioned in previous question in case of recurrent aboions.

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