Background: Unexplained Recurrent miscarriage remains a frustrating problem for the clinician and a distressing condition for the affected couple. Recurrent pregnancy loss is defined as three or more successive spontaneous abortion. The incidence of recurrent pregnancy loss is 1-%2 in the fertile population. The etiology is often unclear and may be multifactorial, with much controversy regarding diagnosis and treatment. This study aimed to find out any difference in uterine artery pulsitility index (PI) between women with history of recurrent unexplained first trimestric abortion and women without this history. Methods: This study was a case-controlled study which included 111 women attended to outpatient clinic of obstetrics and Gynecology Benha university hospitals to find out any difference in uterine artery pulsitility index (PI) between women with history of recurrent unexplained first trimestric abortion and women without this history. Results: The mean age in all women was %7.92 . in Study group, the mean age was 81.13 ± 2.38 ranged between %1 to 83 years while in Control group the mean age was %3.72 ± 1.991 ranged between %1 to 89 years. There were no statistically significant differences between Study group and control group regarding the mean age. In Study group, the mean BMI was %3.29 ± 2.79 while in Control group the mean BMI was %9.13 ± 8.%1. The mean times of previous parity in study group was %.1% ± 1.1%8 while it was %..% ± 1.883 in control group. There were no statistically significant differences between Study group and control group regarding the mean BMI and parity. There were no statistically significant differences between Study group and control group regarding the mean Serum Progesterone level which was Serum Progesterone ng/ml in study group and was 12.2 ± %.12 ng/ml in control group.Regarding Pulsatility index (PI) in right uterine artery in Study group and control group there was a statistically significant difference with mean value %.88 ± 1.27 and %.9% ± 1..7 respectively which reflected increased resistance to blood flow in the right uterine artery in Study group. Comparing PI of left uterine artery in Study group and control group, revealed a significant difference, this indicated increased blood flow resistance in left uterine artery in Study group. As regards PI of both right and left uterine arteries in Study group and control group a statistically significant difference was found. Also we found a statistically significant difference between Study group and control group regarding RI. Based on ROC, the area under the curve was 1.713 with a standard error of 1.18 (712 CI: 1.3.-1.73), which implied that the PI could perfectly predict the occurrence of the adverse outcome among pregnant women. Similarly, the cut-off value for PI was %..1 at 7%2 sensitivity and 312 specificity for miscarriage. Conclusion: Transvaginal ultrasonography colour Doppler flowmetry can be used to Assess uterine perfusion through measurement of uterine artery Doppler (PI) is recommended as routine investigation for women with Unexplained Recurrent miscarriage which helps in managements and treatment protocols. |
