Bad Obstetric History (BOH)
What is Bad Obstetric History (BOH)?
The term Bad Obstetric History indicates the woman who has issues in previous and present pregnancies. These pregnancy issues include stillbirth, miscarriage, and other unwanted conditions. According to WHO, previous fatal outcomes of more abortions, Intrauterine growth restriction, and fetal death are implied by Bad Obstetric History (BOH). In this article, we are going to discuss the cause, history, treatment, and tests of Bad Obstetric History.
Causes Bad Obstetric History (BOH)
The causes of Bad Obstetric History (BOH) depend on different reasons. These are –
- Stillbirth– The still birth indicates the newborn who does not breathe after the period of viability. After the delivery, he/she doesnot show any sign of life. The cause behind it is trauma pregnancy and birth asphyxia.
- Baby with low weight– The reason behind low weight is maternal stress, abnormal placentation, uterine abnormality, chronic medical condition, insufficiency of the placenta, infection, and heavy bleeding in Choriodecidual space, etc. It can result in pulmonary syndrome, fatal shock, dehydration, respiratory problem, and cerebral hemorrhage.
- Intrauterine death– It implies the death of the baby in the uterus and a fatal demise. In the 2oth week of pregnancy, women can feel the movements of the baby but in this case, they cannot feel that. There is a basic difference between stillbirth and intrauterine death. Stillbirth indicates the baby doesn’t respond after birth but in case of intrauterine death, the baby doesn’t respond in the uterus of the mother. This can happen due to genetic abnormalities.
- Prolonged labour– It has a huge reason behind it. The disproportion of contracted pelvis fetopelvic, tumor n pelvic, malposition and male proportion and in fetus congenital anomalies. Too long labor causes low oxygen levels and abnormality in the heart rhythm in the baby.
- Recurrent loss of a pregnancy– It indicates more than two spontaneous pregnancy losses. It causes hypertensive disease, endocrinal, cervical incompetence, and syndrome- thrombophilia Antiphospholipid antibody. This can be genetic as well.
Treatment for bad obstetric history
The method of treating bad obstetric history mainly depends on the cause of BOH. There are some common procedures for treatment. These are-
- When endocrine causes are the reason behind the BOH, the levels of prolactin need to get monitor along with anti-thyroid antibodies and Thyroid Stimulating Hormone in the body.
- Some antibodies can cause BOH. For this, the process of the TORCH test is needful to screen the infection.
- Other than this, Karyotype analysis is another treatment that is useful in the case of habitual abortion. With this type of treatment, we can evaluate the number of chromosomes along with the structure. It can help in the detection of abnormalities. When it comes to the case of habitual abortion, the parents and the aborted fetus get tested through it.
- They can get help from having a supplement of Vitamin D.
- The problem of hypothyroidism and treatment of bromocriptine must be done.
These are the treatments, the doctors follow for bad obstetric history.
Bad Obstetric History (BOH) profile test
The infection in urine can lead to recurrent abortion and the BOH panel tries to find these common agents which are causing this. It is applicable in the case of spontaneous abortions and unexplained fatal deaths.
- For this test, you need to do overnight fasting as per the rule.
- You need to fill the Coagulation Requisition form, this is a mandatory process.
- There are some recommendations from doctors for avoiding affected results. These are- They ask patients to stop Oral Anticoagulants and Heparin for 7 days and 1 day respectively. To stop this, you should consult your treating physician.
- The test components are- anti-nuclear antibody, phospholipid antibodies panel, lupus anticoagulant by dRVVT, TSH Ultrasensitive, and Cardiolipin antibodies panel.
- The test methods are- EIA, CLIA, and Electromechanical clot detection.
Why BOH profile test performed?
In case of offering recurrent pregnancy losses, the doctor needs to consider the situation and psychological needs of the couples. The problem of child death is physically traumatic and affects emotionally a lot. The termination of pregnancy crushes all the hopes of the parents. They need a solution for it. So, profile testing is the best way. Once the issue is detected, it becomes easier for treatment.
First of all, we need to find the cause of the problem. Here, maternal age, poor blood supply, stress, smocking and issue with blood clotting are major problems. The history of bad obstetric history is very important because it provides the details about the problem. This can prevent the situation from facing the same again. The chance of live birth and successful pregnancy get increased.
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MS Obs & Gynae (Gold Medallist). Dr Ankita Nigam has 3+ years of experience in IVF, Infertility and Gynaecology. She conducts and assists in OPD at our Indirapuram and Meerut centres. She actively assists IVF consultants in all procedures. She takes care of the management of various IVF, Infertility, Pregnancy care patients. She has done a special training in "Ultrasound Whole abdomen and Obstetrics & Gynaecology" from Thomas Jefferson University Philadelphia US.
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