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• W2889638897 abstract "To compare the rate of abnormal and actionable results on products of conception (POC) testing from women with and without recurrent pregnancy loss (RPL). Retrospective analysis of results on POC samples. Fresh POC samples were shipped with maternal blood samples to a reference lab for analysis. Genotyping was performed using Illumina CytoSNP-12b microarrays and bioinformatics. Diagnosis codes were reviewed and grouped by RPL vs RPL not indicated (non-RPL). Cases with fetal results, in which maternal cell contamination was ruled out, were categorized as normal or abnormal and included aneuploidy, triploidy, deletions (dels), duplications (dups), single chromosome UPD, or full paternal UPD. Results warranting parental studies or maternal medical management were termed actionable (dels/dups, triploidy and full paternal UPD); those with no follow-up indicated were labeled non-actionable. 2044 fetal POC results were reviewed. RPL was identified in 491 cases and non-RPL was found in 1553 cases. The binomial confidence interval was calculated for each group. Two categories of actionable results were highlighted in this study. The first, triploidy and full paternal UPD, may be associated with molar pregnancy and a risk of gestational trophoblastic disease (GTD) warranting maternal medical follow-up. The second, dels/dups, indicate a risk of parental balanced chromosome rearrangement and possible higher risk for miscarriage and/or offspring with chromosomal imbalances. Guidelines set forth by ACOG as well as other professional societies only recommend POC studies after the second consecutive pregnancy loss .1,2 This study demonstrates no statistical difference in the rates of abnormal and actionable results between patients with or without RPL, calling into question the currently established guidelines. Our results underscore the benefit of offering POC chromosome analysis to all patients, to provide an explanation for the loss, direct recurrence risk counseling and impact medical management. This study demonstrates that RPL alone is not a reliable indication for determining when POC testing is medically appropriate.Tabled 1Results of cases with RPL vs. non-RPL.RPL Casesnon-RPL CasesAverage Maternal Age (years)34.5 (range 21-45)34.4 (range 17-47)Average Gestational Age (days)64.2 (range 34-192)69.7 (range 16-284)Normal208/491 (42.4% +/- 4.37%)694/1553 (44.7% +/- 2.47%)Abnormal283/491 (57.6% +/- 4.37%)859/1553 (55.3% +/- 2.47%)Actionable results: total65/491 (13.2% +/- 2.99%)176/1553 (11.3% +/- 1.57%)Actionable results: del/dups19/491 (3.9%+/-1.7%)58/1553 (3.7%+/-0.94%)Actionable results: triploidy/UPD46/491 (9.4%+/- 2.6%)118/1553 (7.6%+/-1.3%)Non-actionable results426/491 (86.8% +/- 2.99%)1377/1553 (88.7% +/- 1.57%) Open table in a new tab" @default.
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• W2889638897 date "2018-09-01" @default.
• W2889638897 modified "2023-10-18" @default.
• W2889638897 title "Reevaluating guidelines for products of conception testing: chromosomally abnormal and actionable results are similar across patients with and without a history of recurrent pregnant loss" @default.
• W2889638897 doi "https://doi.org/10.1016/j.fertnstert.2018.07.183" @default.
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