Abstract

Background: Unexplained recurrent pregnancy loss (RPL) still poses a diagnostic and therapeutic challenge which can be quite distressing to the couples as well as to the gynaecologist. We aimed to study the prevalence of RPL at our tertiary care centre and to assess the efficacy of Applebaum scoring of endometrium for prediction of implantation in cases of unexplained RPL. Materials and Methods: The study enrolled 43 cases with history of unexplained RPL in non pregnant state and their endometrial evaluation was done with TVS and colour Doppler. 37 patients were taken as controls which were comparable in terms of socio-demographic factors in the age group of 18-35 years. TVS was done on 12th day of menstrual cycle. Results: The incidence of RPL at our center was found to be 3.68%. It was seen that pregnancy loss was more when endometrial thickness was <7mm or >14 mm. RPL was more when pulsatility index of uterine artery was >2.5 (p=0.004) which was statistically significant as compared to controls. It was observed that when total score was <13, the sensitivity and specificity of predicting implantation was 90.70% and 81.08% respectively. Conclusion: Applebaum scoring system can be a good predictor in patients with recurrent pregnancy loss especially when no cause has been identified, accordingly therapeutic intervention can be directed to increase endometrial thickness, its vascularity as well as its receptivity.

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