| Recurrent miscarriage and hCG supplementation: a review and metaanalysis. | |
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MedLine Citation:
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PMID: 20653339 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Human chorionic gonadotropin (hCG) has been used to prevent subsequent miscarriages after previous recurrent miscarriages. In addition to the luteotrophic effects, hCG has uterine immune and autocrine actions. hCG also affects cytokine expression. A Cochrane database systematic review has indicated that hCG seems to prevent further miscarriages, (OR for miscarriage = 0.26, 95% CI 0.14-0.52). However, the trials in the Cochrane database were not matched for the number of miscarriages, 1°, 2° or 3° aborter status, maternal age, etc. and no account was made for chromosomally abnormal pregnancies. All of these impact on the subsequent prognosis and may confound the results. The previous trials in the literature all assessed urinary (u-hCG) rather than recombinant hCG (r-hCG), raising the question whether the effect on pregnancy outcome is due to hCG itself, or other urinary proteins present in u-hCG. A new trial is indicated in which r-hCG is compared to u-hCG and the most effective compared to placebo. Treatment and placebos arms should be stratified for the prognostic factors above and the results corrected for fetal chromosomal aberrations. Until such a trial is carried out, the use of hCG supplementation is empiric. |
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Authors:
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H J A Carp |
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Publication Detail:
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Type: Journal Article; Meta-Analysis; Review |
Journal Detail:
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Title: Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology Volume: 26 ISSN: 1473-0766 ISO Abbreviation: Gynecol. Endocrinol. Publication Date: 2010 Oct |
Date Detail:
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Created Date: 2010-09-13 Completed Date: 2010-12-14 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8807913 Medline TA: Gynecol Endocrinol Country: England |
Other Details:
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Languages: eng Pagination: 712-6 Citation Subset: IM |
Affiliation:
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Department of Obstetrics and Gynaecology, Sheba Medical Center, Tel Hashomer, Israel. carp@netvision.net.il |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Abortion, Habitual
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diagnosis,
immunology,
prevention & control* Autocrine Communication Chorionic Gonadotropin / pharmacology, therapeutic use* Female Humans Pregnancy Prognosis Uterus / drug effects |
| Chemical | |
Reg. No./Substance:
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0/Chorionic Gonadotropin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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