Cell-free DNA Analysis of Chromosome Anomalies in Early Pregnancy Loss
Early Pregnancy LossThe study assesses the accuracy of cell-free DNA (cfDNA) analysis in detecting whole chromosomal aneuploidies from maternal plasma of patients with early, missed miscarriage.
Fetal Loss in Women With Unprovoked Thromboembolism (FLUTE)
Venous ThromboembolismFetal DeathThe purpose of this study is to determine the risk of fetal loss in women with unprovoked venous thromboembolism (VTE) who do not have identifiable inherited thrombophilia compared with women who have the diagnosis of venous thromboembolism (VTE) excluded.
Prediction of Preeclampsia and Other Pregnancy Complications Following Combined Iterative Screening...
PreeclampsiaPreterm Birth2 morePreterm birth (PTB), preeclampsia (PE), fetal growth restriction (FGR) and intra-uterine fetal death (IUFD) constitutes the main causes of perinatal morbidity and mortality and are called "Great Obstetrical Syndromes". Algorithms to predict those outcomes have been developed by combining maternal characteristics (history, age, BMI, blood pressure), biochemical (sFlt-1, β-hCG, PlGF, AFP) and sonographic (uterine artery Doppler, 3D of placenta, cervical length, nasal bone measurement, nuchal translucency) markers. Another prospective observational study ("PREDICTION study" NCT 02189148) is also ongoing, which aims to validate those algorithms at the first trimester of pregnancy. Recent data suggest that repeating the same measurements later in pregnancy could improve the detection rates, allowing closer monitoring of high-risk patients and potential therapeutics under investigation. The current study (PREDICTION2) is an ancillary study of PREDICTION and aims at validating the use of these markers in a combined iterative manner in the prediction of preeclampsia and other obstetrical outcomes.
Biochemical Pregnancy Loss. A Multicenter Retrospective Study
Pregnancy LossEarlyBiochemical pregnancy loss (BPL) is a very frequent issue in human reproduction. After the implantation of the embryo, hCG disappears very soon from the maternal bloodstream and no evidence of a clinical pregnancy is seen. Different studies showed that factors such as age, oocyte and embryo quality, and endometrium receptivity may have something to do with the occurrence of biochemical pregnancy loss post assisted reproduction treatment. The main aim of this study is to evaluate the incidence of biochemical pregnancy loss (BPL) in three different cohort populations; patients undergoing frozen embryo transfer (FET) from own oocytes after preimplantation genetic testing for aneuploidy (PGT-A), patients undergoing FET from own and donated oocytes and with endometrial receptivity array (ERA), and patients undergoing FET from own or donated oocytes (without PGTA or ERA test). We will analyse the incidence of BPL in these populations and try to determine the role of the euploid status embryo in the first group, the endometrium in the second group and the third one as control group. We are waiting to find the value of both players in the origin of BPL.
Evaluation of the Incidence of Cancer in the Follow-up of Women With 3 Consecutive Embryonic Demises...
Antiphospholipid SyndromePregnancy Related1 moreA number of case reports describe the association of antiphospholipid antibodies (aPL Abs) with hematological and solid organ malignancies. Especially in elderly patients, thrombotic events associated with aPL Abs can be the first manifestation of malignancy. Cancer-associated monoclonal gammopathy of the IgM type can be accompanied by positive lupus anticoagulant (LA) or an anticardiolipin (aCL) IgM. Cancer and antiphospholipid antibody syndrome (APS) can coexist in sporadic cases, while some cancer patients with or without thrombosis may show some transitory aPL Ab positivity, the most striking symptomatic clinical feature, catastrophic APS, being even described in cancer patients. Some reports suggest a significant incidence of malignancies in APS patients. Cancer was the 2nd cause of death (13.9%), after bacterial infection, during the 10-year follow-up of the 1,000 APS patients studied by the Euro-Phospholipid Project Group, but no control group was simultaneously evaluated. The risk of cancer in patients with APS is thus still uncertain. The Nîmes Obstetricians and Haematologists APS (NOH-APS) study was based on the recruitment of a cohort of women with no history of thrombosis, who had experienced pregnancy loss fulfilling the clinical criteria of obstetrical APS (oAPS), who were either positive for aPL Abs (APS group), or positive for the F5 rs6025 or F2 rs1799963 polymorphism (Thrombophilia group), or negative for thrombophilia screening (Control group). We now want to assess the comparative incidence of cancer in women for whom an oAPS diagnosis had been made. This evaluation will be carried out during the 2017 medical follow-up step, corresponding to a median follow-up of 17 years. An external, local population-derived control group, the registry of tumors in Montpellier area (Registre des Tumeurs de l'Hérault) will be used to compute standardized incidence ratios (SIRs).
Association of HY-restricting HLA Class II Alleles, Sex of Firstborn Child, and Pregnancy Outcome...
Recurrent Pregnancy LossThis cross-sectional and prospective cohort study will investigate if sRPL patients with a first born boy who carry ≥1 HY-restricting (HY-r) HLA class II alleles are associated with a lower chance for a succesful reproductive outcome in first pregnancy after admission compared to sRPL patients with a first born girl carrying ≥1 HY-r HLA class II alleles and women with no HY-r HLA class II alleles and a firstborn boy. Also, the study will compare sRPL patients with a firstborn boy who do not carry a HY-r HLA class II allele with sRPL patients having a firstborn girl and carrying no such alleles. We hypothesize that sRPL patients with a first born boy compared to sRPL patients with a firstborn girl who carry ≥1 HY-r HLA class II alleles is associated with a negative prognosis, while no association between sex of firstborn child and pregnancy outcome is expected in sRPL carrying no HY-r HLA class II alleles. Neither do we expect an association between pregnancy outcome and carriage of HY-r HLA class II alleles in pRPL patients.
Antenatal Palliative Care
Fetal DeathFetal AnomalyIn France, according to current legislation, termination of pregnancy could be performed without any upper gestational age limit, if there is a strong probability that the fetus will be affected by a particularly severe and incurable disease. When there is a lethal fetal diagnosis most of parents wish to terminate their pregnancy. However, and despite some medical resistance a few of them do wish to continue pregnancy. In these situations, palliative care seems to be a good way to prepare to welcome the child and surround him until death. The aim of the study is to describe parents' experience for a better understanding and a better care.
Analysis of All Stillbirths in Stockholm County 2017, a Multidisciplinary Audit
Intra-Uterine DeathAll stillbirths in Stockholm during 2017 were analysed according to the primary outcomes which were preventable/non-preventable deaths and the level of delay. The secondary outcomes were: causes of death, standard of care pre and post stillbirth and if a summary of the possible causes of death was made as well as the planning of supervision of the next pregnancy.
Ultrasound Predictors of Early Pregnancy Failure in Patients With Recurrent Pregnancy Loss
Recurrent Pregnancy LossEarly Pregnancy Failureevaluation of the role of ultrasonographic parameters (mean gestational sac diameter, yolk sac diameter, crown rump length, embryonic heart rate and uterine artery Doppler) in predicting early pregnancy failure in patients with recurrent pregnancy loss
Evaluation of the Serum Markers sFLt1 and PlGF for the Prediction of the Complications of the Placental...
Pre-EclampsiaHELLP Syndrome5 moreThe pre-eclampsia is a frequent pathology, concerning approximately 5 % of the pregnancies.The pre-eclampsia can evolve into severe maternal and\or foetal complications and is a major cause of mortality. The purpose of the study will to estimate the relevance of the serum markers sFlt1 and PlGF to predict the arisen of severe complications at these patients, what would allow to decrease the materno-fœtale morbi-mortality due to the pathology.