الفهرس 
MiscarriageOnly 14 pages are availabe for public view
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Abstract
The commonest early pregnancy complication , spontaneous miscarriage occurs in approximately 15–20% of all pregnancies, as recorded by hospital episode statistics. The actual figure, from community based assessment, may be up to 30%, as many cases remain unreported to hospital, The great majority occur early before12 weeks gestation, while mid trimester loss, between 12 and 24 weeks, occurs less frequently and constitutes <3% of all pregnancy outcomes.
Recurrent miscarriage (RM), is defined as the loss of three or more pregnancies. Recurrent miscarriage is a heterogeneous condition that has many possible causes; more than one contributory factor may underlie the recurrent pregnancy losses
Three-fourths of spontaneous abortion occurs before 16th week; of these, 75% occur before eighth week. Almost 20% of clinically recognized pregnancies terminate in spontaneous abortion.
Causes of spontaneous abortion can be summarized to be: chromosomal abnormalities, infection, hormonal problems, incompetent cervix, immunological disorders, uterine abnormalities, nutritional and environmental factors. In many cases of miscarriage, no obvious cause was found. Placenta growth factor, a member of the vascular endothelial growth factor family, is a 132-amino acid residue, 50-kDa dimeric glycoprotein, and shares a number of biochemical and functional features with other members of the vascular endothelial growth factor family.
Placental growth factor is an important local mediator of angiogenesis and prominent expression of placental growth factor has been identified in placenta, human umbilical vein endothelial cells, and choriocarcinoma cell lines. In the placenta, placenta growth factor is produced mainly by the cytotrophoblast, syncytiotrophoblast, and extravillous trophoblast. Previously, decreased levels of placenta growth factor in pre-eclamptic patients after the clinical manifestations occurred had been reported, mostly in the third trimester.
Placenta growth factor (PIGF) has been the second member of VEGF family discovered. The name refers to placenta since it was cloned from a human placental cDNA library.
The growth-related factors are altered in pregnancies accompanied by fetal intrauterine growth retardation (IUGR). Low serum PIGF levels are detected in the second half of the pregnancy in clinically presented cases with IUGR. IUGR is associated with increased perinatal morbidity and- mortality. Impaired neurological development, and negative long-term consequences in adult life.
Intrauterine implantation has been associated with the activity of placental growth factor (PIGF).
In the present study we recruited 50 pregnant women at 6-14 weeks of gestation from the women who attended to antenatal care clinic of Benha University Hospital between February 2013 and September 2013. Samples were collected for our study.
For each case, a full history, general and local examinations were done and cases were divided into 2 groups:-
¬¬Group 1 (study group):
Included 25 pregnant patients with threatened miscarriage.
Group 2 (the control group):
Included 25 pregnant patients with normal uncomplicated first trimester intrauterine pregnancy
The results of our study concluded that there was statistically significant relation between PIGF and first trimester miscarriage when comparing pregnant women with threatened abortion with women with normal pregnancy. PIGF is considered better positive than negative with higher sensitivity in prediction of threatened abortion (Best cut off=20.5). PIGF is considered better positive than negative with higher sensitivity in prediction of complete abortion( Best cut off=10.3)
from the result of our study and the results of the previous study it seems that screening of PIGF would predict miscarriage rates, particularly in the first trimester.