الفهرس | Only 14 pages are availabe for public view |
Abstract Study question? Is Porphyromonas gingivalis infection more prevalent in patients with primary unexplained recurrent early pregnancy loss? Summary answer: P. gingivalis infection seems to be significantly more prevalent in patients with primary unexplained recurrent early pregnancy loss when compared to patients with single missed miscarriage. What is known already- from previously published studies, P. gingivalis infection was associated with preterm birth. One of these studies showed that the mechanism by which P. gingivalis may cause preterm birth was through certain inflammatory mediators. - As recurrent early pregnancy loss was shown to be an inflammatory process, too, a suggestion was made that such infection may have a role in the aetiology of recurrent early pregnancy loss. Study design, size, and duration: A cross sectional study was conducted in a tertiary care maternity centre during a 1- year period. Participants, materials, setting & methods:- Fifty patients with first trimester unexplained recurrent early pregnancy loss admitted for surgical termination of pregnancy for early pregnancy failure were included as the study group (group I), along with 50 patients presented with first trimester missed miscarriage with no history of recurrent early pregnancy loss as the control group (group II). - For all included patients samples taken from the evacuated products of conception, subgingival plaques, cervicovaginal secretions and saliva were subjected to polymerase chain reaction (PCR) for detection of P. gingivalis DNA. Main results and the role of chance - A total of 100 patients were included in the study. - There was a significantly higher proportion of patients who were positive for P. gingivalis DNA existed in the villous samples in group I when compared to patients of group II [8 (16%) versus. 1 (2%), respectively, P=0.036]. - P. gingivalis in villous samples was significantly almost 9-fold more prevalent in women of group I [OR 9.3, 95% CI (1.1 to 76.9)].- There was a statistically significant difference between group I and group II regarding the proportion of patients who were positive for P. gingivalis DNA existed in cervicovaginal secretions [9 (18%) versus. 1 (2%), respectively, P=0.02, OR 10.8, 95% CI (1.3 to 88.5) ]. - P. gingivalis DNA was not found in subgingival plaques and saliva samples in both groups. Limitations & reasons for caution - No published data regarding the presence of P. gingivalis infection in patients with recurrent early pregnancy loss were available.- Pre-study sample size was not, therefore calculated. Fifty patients in each group were empirically chosen. - As being a case control study, risk association cannot be reliably assessed and an aetiological association cannot be concluded. |