Bad Obstetric History

Bad Obstetric History

What is Bad Obstetric History?

Bad Obstetric History (BOH) means a woman who had unfavorable pregnancy conditions in the past. Unfavorable conditions are — stillbirth, miscarriage, intrauterine fetal demise, consecutive abortions, early neonatal deaths and others. Pregnancy loss puts couples in distress. It stands as a challenge for doctors and clinicians as well. It can also push mothers to depressive states. During the stages of pregnancy, issues can arise anytime. Thus regular check-ups are recommended.

Emotional issues happen due to consecutive pregnancy losses. An inspection of the uterus environment will uncover the reasons for miscarriage. Around one percent of pregnancies go through repetitive miscarriages. A little more than five percent of pregnancies have BOH.

Everything You Need to Know About Bad Obstetric History

Classification | Causes | Treatment | Profile Test

Classification of BOH

Bad Obstetric History is classified into the following:

Intrauterine fetal demise

Medical condition where the pregnant mother loses her child in the womb after five months in pregnancy. An unfortunate incident may occur due to infection or genetic disease. Doctors examine the mother and baby thoroughly to know the cause of Intrauterine fetal demise. Causes of stillbirths include problems with the placenta, irregularity in genetics, complications in the umbilical cord, ruptured uterus. This kind of death depends on three factors—placental, maternal and fetal.

Abortions

Many women do abortions for birth control. However, it has side effects as well. A woman faces a lot of changes. Repetitive abortions may be fatal to a woman. Late abortions are also not a good choice. Consecutive abortions may put the woman’s life at the edge.

Preterm Labour

A pregnancy lasts 40 weeks normally. Any pregnancy labour that happens before the 37th week is known as Preterm labour. Sadly it can result in premature birth, needs medical attention immediately. It brings risks to the health of the baby. Premature babies need special care in the neonatal intensive care ward. Even after the early threat is gone, the child still develops mental or physical disabilities. Symptoms of preterm labour are frequent contractions, constant backache, abdominal cramps, vaginal bleeding, early rupture of membranes in the womb etc.

Anomalies in the foetus

Unexpected developments in the baby during the pregnancy. There are two types of fetal anomaly, structural anomaly and functional anomaly. Structural happen in organs like the heart, kidney, liver, lungs. It also occurs in limbs and bones. On the other hand, Functional anomalies affect the brain and the nervous system. Down syndrome is a functional anomaly. Not everyone needs treatment. The environment, genetics, viruses and chemical in medicines/food/drinks are few factors that affect anomaly.

Neonatal demise

Neonatal demise means when a baby dies within the first twenty-eight days of the pregnancy. In research, neonatal deaths occur in less than one per cent of pregnancies in the USA. The causes of neonatal demise are defects at birth, low birth weight, premature birth etc. Brain conditions, genetic conditions, lung defects and heart defects are the defects that most likely cause such deaths. Prenatal tests like Amniocentesis, CVS, and Ultrasound will detect defects.

Intrauterine growth restriction

Pregnancy condition where the baby does not grow to the expected weight. During the pregnancy, the baby falls short in the size expected in the weeks. Problems with the placenta or umbilical cord can give rise to fetal growth restriction. Another problem is if the mother has high blood pressure. Tests to check such abnormalities are Doppler Ultrasound, Fundal height, Fetal Ultrasound. Consuming alcohol and cigarettes increases the risk of having growth restrictions in the baby.

Related Conditions

Causes of Bad Obstetric History (BOH)

Different factors contribute to Bad Obstetric History (BOH). Here they are:

Stillbirth

After the time of viability, the infant who has stopped breathing is said to have given birth to a still. He/she does not exhibit any signs of life after birth. Trauma during pregnancy and birth hypoxia is to blame.

Low-weight baby

Insufficient placenta, infection, and excessive choriodecidual hemorrhage are all possible causes of low birth weight, as are maternal stress, aberrant placentation, uterine abnormalities, and chronic medical conditions. Hemorrhage in the brain and pulmonary syndrome are all possible side effects.

Intrauterine death

This means that the baby has died within the uterus and that the mother has met her death. Women normally feel the baby’s movements by the 20th week of pregnancy, but in this instance, they are unable to. Stillbirth differs fundamentally from intrauterine death. Stillbirth implies that the baby does not react after birth, however, if the baby dies within the mother’s uterus, it does not respond after delivery. Genetic disorders may be to blame.

Prolonged labor

There’s a good explanation behind this. Fetopelvic disproportion, tumor n pelvic, male proportion malposition, and congenital abnormalities in fetuses are all examples of this. Low oxygen levels and irregular heart rhythms in the newborn are side effects of labor that lasts too long.

Recurrent loss of a pregnancy

It shows that there have been more than two spontaneous miscarriages. It results in hypertension, endocrine dysfunction, cervical dysfunction, and a blood clotting disorder called syndrome thrombophilia. A monoclonal antibody against phospholipids. It’s also possible that this is hereditary.

Treatment for bad obstetric history

The treatment approach for a poor obstetric history is mostly determined by the underlying reason. There are a few standard therapy methods. These are the things that

  • When endocrine factors are to blame for BOH, prolactin levels, anti-thyroid antibodies, and Thyroid Stimulating Hormone levels in the body must be monitored.
  • BOH may be caused by certain antibodies. The TORCH test is required to screen for infection in this procedure.
  • In addition to this, Karyotype analysis is an effective therapy for women who have a pattern of aborting their babies. We can determine the number of chromosomes and their structure using this procedure. In the identification of anomalies, it may be helpful. When it comes to habitual abortion, it puts both the parents and the aborted child to the test.
  • They may benefit from taking a Vitamin D supplement.
  • Bromocriptine therapy and the hypothyroidism issue must be addressed.
  • These are the approaches physicians use when treating women with a history of miscarriage or stillbirth.

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Sexologist and Infertility Specialist

12+ Years of Experience as
Sexologist and Infertility Specialist

Bad Obstetric History (BOH) profile test

Recurrent abortions may be caused by an infection in the urine, and the BOH panel is looking for the common agents that are causing this. It may be used in cases of ectopic pregnancy, sudden abortions, and mysterious deaths.

  • You must fast overnight before taking this exam since it is required by the rules.
  • You must complete the Coagulation Requisition form.
  • Doctors have advised on how to prevent having your findings tainted. Oral anticoagulants and heparin must be stopped for seven days and one day, respectively. Consult your treating physician if you want to put an end to this.
  • It includes an anti-nuclear antibody, phospholipid antibodies panel, lupus anticoagulant by dRVVT, TSH ultrasensitive, and cardiolipin antibodies panel. These are the many components of the check.
  • EIA, CLIA, and electromechanical clot detection are all acceptable techniques of testing.

Conclusion

Major issues include mother age, low blood supply, stress, smoking, and blood coagulation issues. Because it offers information about the issue, a woman’s poor obstetric history is critical. This will help to avoid a recurrence of the problem. The likelihood of giving delivery and having a healthy pregnancy increases. The reason for this is so that our experts can better comprehend therapy options. To know more you can contact us.

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Dr. Ramit Kamate is a Reproductive Medicine Consultant and Sexologist with experience of 12+ years. He specialises in Sexual Medicine for male and female, Fertility Treatment, Pre and Post Delivery Care, Normal Vaginal Delivery (NVD), Tubectomy/Tubal Ligation, Natural Cycle IVF, MTP.

Dr. Ramit Kamate finished MBBS from B J Medical College, Pune. He pursued Masters’s In Reproductive Medicine from Hamilton University, UK & IBCME Dubai. Completed Fellowship in Cosmetic Gynaecology and Sexual Medicine from USA.

Bad Obstetric History

by | Oct 12, 2021

Bad Obstetric History

by | Oct 12, 2021

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