Cover -- Half-title -- Title -- Copyright -- Contents -- Contributors -- Preface -- Chapter 1 Early pregnancy - models of healthcare -- Introduction -- Evolution -- Recognizing the event -- Length of pregnancy -- Ultrasound criteria -- Classification of events -- Future direction -- Conclusions -- References -- Chapter 2 Risk factors for miscarriage -- What is a miscarriage and how common is it? -- Why does miscarriage happen? -- Chromosomal abnormality in the fetus -- Maternal and paternal age -- Previous reproductive history of the mother -- Socio-economic status -- Pre-pregnancy weight -- Diet -- Caffeine intake -- Alcohol intake -- Mother -- Father -- Smoking -- Mother -- Father -- Physical and psychological stress -- How can women and their partners be advised about miscarriage? -- The concept of risk -- Which risks to discuss? -- Emotional reactions -- Was it something I did? -- Information and support -- Coping strategies when dealing with risk -- Dealing with stress -- Summary -- References -- Chapter 3 Ectopic pregnancy -- Types of ectopic pregnancy -- Risk factors -- Diagnosis -- Surgical diagnosis -- Ultrasound diagnosis -- Management -- Surgical management -- Medical management -- Expectant management -- Subsequent fertility -- Summary -- References -- Chapter 4 Ultrasound detection of congenital uterine anomalies -- Introduction -- Background -- Diagnosis -- Twoimensional ultrasound -- Transabdominal ultrasound -- Transvaginal ultrasound -- Three-dimensional ultrasound -- Magnetic resonance imaging -- Clinical consequences -- Reproductive performance -- Uterine anomalies in early pregnancy -- Conclusion -- References -- Chapter 5 Ultrasound and early pregnancy -- Introduction -- Normal findings in early pregnancy -- Normal early pregnancy milestones -- Intradecidual sac sign -- Double decidual sac sign -- Gestation sac with yolk sac.

Visualization of the amnion -- Normal embryonic development -- Placental development -- First trimester findings in multiple gestations -- Ultrasound findings in early pregnancy failure -- Failure to meet milestones -- Abnormal sac -- Embryo to sac size discrepancy -- Embryonic demise -- Empty uterus -- Retained products of conception -- Abnormal findings in first-rimester pregnancy -- Abnormal yolk sac -- Chorionic bump -- Embryonic bradycardia -- Echogenic fluid in the cul de sac -- Gestational trophoblastic disease -- Perigestational hemorrhage -- Fetal anomalies -- Adnexal mass -- Conclusion -- References -- Chapter 6 Management of pregnancy loss -- Introduction -- Epidemiology -- Natural course and clinical findings -- Diagnostic management -- Prevention of early pregnancy loss -- Therapeutic management -- Future research -- Acknowledgment -- References -- Chapter 7 Investigation of recurrent miscarriage -- Investigative algorithm -- History -- Infective screen -- Endocrinological investigations -- Genetic investigations -- Parental cytogenetic analysis -- Cytogenetic analysis of miscarriage tissue -- Detection of anatomical abnormalities -- Thrombophilia testing -- Other thrombophilias -- Immunologic investigations -- Natural killer cells -- Mannan-binding lectin -- Other investigations -- Hyperhomocysteinemia -- Human leukocyte antigen testing -- Idiopathic recurrent miscarriage -- Summary -- References -- Chapter 8 Molar pregnancy -- Introduction -- True molar pregnancies -- Complete hydatidiform mole (CHM) -- Partial hydatidiform moles -- Rare causes of true partial hydatidiform mole -- Pseudoolar pregnancies -- References -- Chapter 9 Uterine natural killer cells and reproduction -- Introduction -- Uterine natural killer cells -- The source of uNK cells -- In-utero proliferation and differentiation -- Trafficking from peripheral blood.

Regulation of menstruation -- The functions of uNK cells -- Regulation of trophoblast invasion and growth -- Regulation via extravillous trophoblast and uNK cell interaction -- Regulation via cytokine production -- Regulation of vascular remodeling -- Uterine NK cells and recurrent miscarriage -- Uterine natural killer cells and recurrent implantation failure -- Conclusion -- References -- Chapter 10 Cytogenetic factors in recurrent early pregnancy loss -- Cytogenetics in human reproduction -- Evaluation of the miscarriage -- Investigation and management of genetic factors in recurrent pregnancy loss -- Premplantation genetic screening and recurrent pregnancy loss -- Summary -- References -- Chapter 11Parental chromosome testing -- Background -- Biological basis of chromosome abnormalities -- Reciprocal translocations -- Technique of conventional chromosome studies -- Recently developed laboratory techniques (molecular cytogenetics) -- Screening strategies -- Pregnancy outcome in carriers -- Counseling and therapeutic options (PND vs PGD) -- Prenatal diagnosis -- Pre-implantation genetic diagnosis -- Summary, conclusions and focus of future research -- Acknowledgments -- References -- Chapter 12 Embryoscopy -- Introduction -- Technique of transcervical embryoscopy -- Dilatation of the cervical canal -- Localization of the gestational sac and assessment of the uterine cavity -- Incision of the chorion and the amnion -- Morphological evaluation of the embryo -- Tissue sampling -- Instrumental evacuation of the uterus -- Embryonic malformations -- Embryonic growth disorganization -- Localized developmental defects -- Head defects -- Trunk defects -- Limb defects -- Umbilical cord defects -- Duplication abnormalities -- Amnion rupture sequence -- Prevalence of embryonic developmental defects in early intrauterine deaths.

Correlation of embryonic morphology and karyotype in early abortion specimens -- Indications for a detailed embryoscopic evaluation of early intrauterine deaths -- Advantages of a detailed embryoscopic and cytogenetic evaluation of early intrauterine deaths: accurate diagnosis of fetal causes of pregnancy loss -- Reliable cytogenetic evaluation of the conceptus -- What additional information can be gained from a morphological examination of the embryo with a normal karyotype? -- References -- Chapter 13 Acquired thrombophilia and recurrent early pregnancy loss -- Acquired thrombophilia and recurrent early pregnancy loss -- Antiphospholipid syndrome -- Screening for Antiphospholipid syndrome -- Prevalence of Antiphospholipid syndrome -- Outcome of pregnancy in women with untreated aPL -- Mechanism of aPL pregnancy loss -- Treatment of Antiphospholipid syndrome in pregnancy -- Corticosteroids and Antiphospholipid syndrome -- Role of aspirin in Antiphospholipid syndrome -- Heparin and Antiphospholipid syndrome -- Intravenous immunoglobulin and Antiphospholipid syndrome -- Antiphospholipid syndrome and recurrent implantation failure -- Hyperhomocysteinemia -- Acquired protein C resistance -- Global markers of prothrombotic disorders -- Future pregnancy management in recurrent miscarriage patients with thrombophilia -- Unexplained recurrent miscarriage and the role of supportive care -- Conclusion -- Acknowledgments -- References -- Chapter 14 Inherited thrombophilia and early pregnancy -- Thrombophilia -- The risk of venous thromboembolism in pregnancy -- Association between thrombophilia and pregnancy failure -- Clinical implications of thrombophilia in early pregnancy -- Prevention of venous thromboembolism in women with thrombophilia without prior venous thromboembolism.

Prevention of venous thromboembolism in women with thrombophilia and a history of venous thromboembolism -- Women with thrombophilia and recurrent miscarriage -- Women with inherited thrombophilia and a single pregnancy loss -- Other observations in women with inherited thrombophilia -- Conclusions -- References -- Chapter 15 Thrombosis, air travel and early pregnancy -- Thrombosis risk and early pregnancy -- Thrombosis risk and travel -- Estimating the thrombosis risk from travel during early pregnancy -- Prevention of travel-elated VTE -- Advice to women who undertake longaul travel during early pregnancy -- References -- Chapter 16 Immunotherapy and early pregnancy -- Introduction -- Allogeneic leukocyte immunization therapy -- Heterogeneity of ALT trials -- Heterogeneity of immunization protocols -- Heterogeneity of patient populations -- Criticism of the Cochrane analysis on ALT -- Intravenous immunoglobulin -- Heterogeneity of IvIg trials -- Heterogeneity of treatment protocols -- Heterogeneity of patient populations -- Criticism of the Cochrane analysis on IvIg -- Negative aspects of immunotherapy in RM -- Allogeneic leukocyte immunization therapy -- Intravenous immunoglobulin -- Harm effects of IvIg -- The costs of IvIg -- Possible mechanisms of action of immunotherapy in RM -- Conclusions -- References -- Chapter 17 Endometrial receptivity -- Summary -- Introduction -- The endometrium as a tissue -- Regulation of the endometrial gene expression profile -- Markers of endometrial receptivity -- Histological dating -- Pinopodes and immunohistochemical markers -- Gene expression markers -- Endometrial receptivity as a global process -- New methods for endometrial receptivity studies -- Conclusions -- References -- Chapter 18 Clinical assessment of the endometrium -- Introduction -- Historical perspective.

Implantation window and defects in uterine receptivity.