الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Recurrent miscarriage, which is defined as three or more miscarriages in a row before the 24th week of pregnancy, affects 0.5–1% of couples. Many specialists describe recurrent miscarriage as three losses or more, which raises the problem’s prevalence from 1 to 5% in couples trying to conceive. It is either primary (women without previous live-born infants) or secondary (women with at least one previously live-born infant). Recurrent pregnancy loss (RPL) can be caused by anatomical, endocrinological, genetic, immunological, microbiological, or environmental variables.
The causes for miscarriage are not yet completely understood. About 40–50% of recurrent miscarriage is classified as idiopathic.
The main reason for this is that miscarriage is extremely difficult to investigate; there are only a few clinical miscarriage registers, and miscarriages are sometimes not even noted in clinical documents. Data shows that abnormalities in the quality and depth of implantation result in unfavourable perinatal complications in all pregnancy’s three trimesters.
Many investigations have hypothesized that RPL is caused by coagulation disorders such as the existence of antiphospholipid antibodies or factor V Leiden, as well as a genetic abnormality producing underlying intolerance to activated protein C or protein S. Many studies have shown that low doses of sildenafil, similar to nifedipine, improve uterine arterial blood flow and improve endometrial and subendometrial vascularity.
Recurrent abortion is best investigated before another pregnancy occurs. Uterine receptivity is thought to be affected by a variety of variables, including uterine perfusion, and is critical to achieving a successful conception. According to research, uterine artery perfusion may affect endometrial receptivity, and inadequate uterine perfusion could be one of the reasons for unexplained miscarriages and, most likely, incorrect implantation. Prior to conception, uterine artery blood flow has stiff opposition to absent or reversed diastolic flow. Noninvasive uterine circulation examination is possible using transvaginal pulsed Doppler ultrasound.
The primary goal of this research was to determine the impact of enhancing uterine artery Doppler measurements in the luteal phase prior to pregnancy, using nifedipine, on pregnancy outcome in patients with recurrent miscarriage.
This prospective randomized clinical trial included 50 participants. 25 women received nifedipine (Epilat tablet 10mg tablet), once daily were matched according to age and BMI with 25 women with placebo intake. All participants were recruited from EL-Shatby university hospital and private centers upon fulfillment of the inclusion and exclusion criteria. Our study was performed from November 2020 to January 2022.
The main findings of the study revealed that:
• Women had age ranged from 25 years to 30 years.
• Regarding uterine artery results, the right and left UtA-PI has decreased significantly after 12 and 24 weeks of nifedipine use with statistical significant difference with the matched group.