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Short Description: It becomes necessary for every woman with. bad obstetric history to undergo ultrasonography, to. rule out any anatomical abnormality, and evaluation ...
Content Inside: 119 J Anat. Soc. India 50(2) 119-121 (2001) Anatomical Causes of Bad Obstetric History Srinivas, N; Rajangam, S. Division of Human Genetics, Department of Anatomy, St. John's Medical College, Bangalore -- INDIA. Abstract. The aim of the present study was to find out the incidence of the anatomical causes from the couples with bad obstetric history referred for karyotyping and counselling. There were 104 couples whose age ranged from 18 - 40 years (mean age 26.79 ± 5.21 years). A detailed proforma has been prepared eliciting the suspected causal factors of bad obstetric history. Any malformation/defect affecting the components of male and female reproductive system may affect the normalcy in reproduction and more so if it is in the uterus. In the present study, in 8 (7.69%) out of 104 females, the anatomical defect could have been the causal factor for the bad obstetric history. These patients had either a tubal block or bicornuate uterus / hypoplastic uterus or polycystic ovaries. Their karyotypes were normal i.e. 46 XX. These patients were later referred to the Obstetricians and Gynaecologists for further surgical procedures. As a part of counselling the "follow up" either in person or through correspondence was emphasised. Key words : Recurrent abortions, Anatomical, Obstetric history. Introduction : Material And Method : Anatomical defects of the reproductive system One hundred and four couples (n=208) with could be one of the commonest causes of bad bad obstetric history were referred to the Division of obstetric history. Approximately 12 - 15% of women Human Genetics, Department of Anatomy, St. with recurrent abortion have uterine malformation John's Medical College, Bangalore, for cytogenetic (Stirrat 1990). The polycystic ovaries, septate investigations and counselling from St. John's uterus, Mullerian anomalies, etc are the anatomical Medical College Hospital, other hospitals, nursing abnormalities linked with recurrent early homes in and around Bangalore. Patients are spontaneous abortions. Uterine abnormalities could referred not only from Karnatka but also from other result in impaired vascularization of pregnancy and states of India especially Andra Pradesh, Tamil limited space for the growing fetus due to distortion Nadu and Kerala. Couples were taken for study only of the uterine cavity. In addition to Mullerian if they had two or more than two abortions or anomalies, another anatomical cause, although neonatal deaths or offsprings with multiple uncommon, of recurrent abortions is Asherman's congenital anomalies. Karyotyping was done with leucocyte microculture and Giemsa Trypsin- syndrome chracterized by intrauterine adhesions. If Giemsa banding method. The proforma included a an appropriate predisposing factor, such as uterine detailed personal and clinical history, pedigree and curettage or a severe uterine infection can be family history, information about appropriate identified, then diagnostic hysterosalpingography or laboratory investigations (semen analysis, hormonal hysteroscopy could be performed. The results with assay, TORCH, ultrasound scanning) and hysteroscopic repair have been impressive (Coulam photographs. 1991). Result and Discussion : The recognition of the anatomical abnormality usually precludes the search for other causes. The Anatomical causes were observed in 8 women and they had 3.13 ± 2.17 abortions (Table 1). Their aim of the study is to report the anatomical factors karyotypes were normal i.e. 46, XX. Anatomical affecting the obstetric history. The information has causes could be congenital or acquired. Congenital been elicited as a part of a detailed study on the anomaly includes Mullerian duct fusion or septum etiology of bad obstetric history. J. Anat. Soc. India 50(2) 119-121 (2001)