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Indian Journal of Obstetrics and Gynecology

Volume  12, Issue 2, April - June 2024, Pages 57-62
 

Original Article

Assessment of Applebaum Scoring in Endometrial Evaluation in Prediction of Implantation in Patients with Recurrent Pregnancy Loss

Kiran Pandey1 , Pavika Lal2 , Aishwina Anand3 , Garima Gupta4 , ShailyAgarwal5

 d Gynecology, Ganesh  Shankar Vidyarthi Memorial Medical College,  Kanpur 208002, 3,4,5Senior Resident, Department of  Obstetrics and Gynecology, Moti Lal Nehru Medical  College, Prayagraj 211002, Uttar Pradesh, India

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DOI: http://dx.doi.org/10.21088/ijog.2321.1636.12224.2

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.


Keywords : Applebaum Scoring; Endometrial Receptivity; Recurrent Pregnancy Loss.
Corresponding Author : Aishwina Anand