title: Etiology of spontaneous abortion before and after the demonstration of embryonic cardiac activity in women with recurrent spontaneous abortion.
abstract: OBJECTIVE
  To analyze the etiologic factors of spontaneous abortion in the first trimester among women with recurrent spontaneous abortion, specifically before and after the demonstration of embryonic cardiac activity.
  
  
  METHODS
  A retrospective analysis included women with recurrent spontaneous abortion admitted to a center in Guangzhou, China, for dilation and curettage after a spontaneous abortion in the first trimester between January 2008 and December 2012. The etiologic factors of spontaneous abortion occurring before versus after the demonstration of cardiac activity were compared.
  
  
  RESULTS
  A total of 232 women were included. Among 146 women with demonstrated cardiac activity before spontaneous abortion, 78 (53.4%) had an embryonic karyotype abnormality, 55 (37.7%) had traditional etiologic factors, and 34 (23.3%) had an unidentified cause. Among 86 women without cardiac activity, 41 (47.7%) had an embryonic karyotype abnormality, 28 (32.6%) had traditional etiologic factors, and 26 (30.2%) had an unidentified cause. After exclusion of abortions involving embryonic karyotype abnormalities, there was a higher incidence of APA positivity in the group with embryonic cardiac activity than in the other group (13/68 [19.1%] vs 1/45 [2.2%]; P=0.008) and a lower incidence of subclinical hypothyroidism (8/68 [11.8%] vs 12/45 [26.7%]; P=0.042).
  
  
  CONCLUSIONS
  The distribution of etiologic factors in spontaneous abortion differs according to whether embryonic cardiac activity is recorded.
authors: Department of Obstetrics and Gynecology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.
authors: Yukun
authors: Y
authors: Liu
authors: Department of Obstetrics and Gynecology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.
authors: Yinglin
authors: Y
authors: Liu
authors: Department of Obstetrics and Gynecology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.
authors: Shuning
authors: S
authors: Zhang
authors: Department of Obstetrics and Gynecology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.
authors: Hui
authors: H
authors: Chen
authors: Department of Obstetrics and Gynecology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.
authors: Meilan
authors: M
authors: Liu
authors: Department of Obstetrics and Gynecology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China. Electronic address: zjp2570@126.com.
authors: Jianping
authors: J
authors: Zhang
mesh_terms: D059786:Abnormal Karyotype / Q000196:embryology; D037881:Aborted Fetus / Q000002:abnormalities / Q000503:physiopathology*; D000026:Abortion, Habitual / Q000209:etiology*; D000328:Adult; D017152:Antibodies, Antiphospholipid / Q000097:blood; D002681:China; D005260:Female; D005318:Fetal Heart / Q000502:physiology*; D006326:Heart Auscultation / Q000379:methods; D006801:Humans; D007037:Hypothyroidism / Q000150:complications; D011247:Pregnancy; D011261:Pregnancy Trimester, First / Q000097:blood; D012189:Retrospective Studies
chemical_list: D017152:Antibodies, Antiphospholipid
keywords: Antiphospholipid antibodies; Karyotype analysis; Recurrent spontaneous abortion; Subclinical hypothyroidism