Clinical presentation, investigation, underlying causes, and subsequent pregnancy outcomes among different phenotypes of second trimester miscarriage

Aim To evaluate the causes of miscarriage and subsequent pregnancy outcomes among different phenotypes of second trimester miscarriage. Methods Retrospective analysis of 170 consecutive second trimester miscarriages between 14 + 0 and 23 + 6 weeks recorded in the Clinical Data Analysis and Reporting...

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Published in:The journal of obstetrics and gynaecology research 2023-02, Vol.49 (2), p.539-547
Main Authors: Cheung, Ka Wang, Seto, Mimi Tin Yan, Wang, Weilan, Mok, Yin Kwan, Cheung, Vincent Y. T.
Format: Article
Language:English
Subjects:
abortion
Abortion, Habitual - etiology
Abortion, Missed
Abortion, Spontaneous - epidemiology
Abortion, Spontaneous - etiology
cervical incompetence
cervical insufficiency
Diabetes mellitus
Female
Fetuses
Humans
inevitable
Karyotypes
Miscarriage
Phenotype
Phenotypes
Placenta
Pregnancy
Pregnancy Outcome
Pregnancy Trimester, Second
Retrospective Studies
second trimester miscarriage
silent
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Summary:Aim To evaluate the causes of miscarriage and subsequent pregnancy outcomes among different phenotypes of second trimester miscarriage. Methods Retrospective analysis of 170 consecutive second trimester miscarriages between 14 + 0 and 23 + 6 weeks recorded in the Clinical Data Analysis and Reporting System from 2012 to 2021. Cases were excluded if miscarriages occurred before 14 + 0 weeks of gestation, data were incomplete, or passage of the fetus happened before the clinical assessment. Cases were classified with a stepwise approach into three phenotypic groups including silent miscarriages (ST‐SM), rupture of membranes (ST‐ROM), and inevitable miscarriages (ST‐IM) depending on the fetal heart pulsation and leakage of liquor at presentation. Clinical investigation of the underlying causes and the outcome of the subsequent pregnancy was then reviewed. Results There were 97 cases of ST‐SM, 21 cases of ST‐ROM, and 52 cases of ST‐IM. Placental histology and karyotype examination were more likely to yield significant results in the cases of ST‐ROM and ST‐SM (p 
ISSN:1341-8076
1447-0756
DOI:10.1111/jog.15514