The term bad obstetric history (BOH) is loosely used to signify that a woman has previously had problems in previous pregnancies. This may include miscarriage, stillbirth or any other adverse and unwanted conditions. Knowing in detail about BOH is important to prevent similar situations and to increase the chances of a successful pregnancy and live birth.

Classification of BOH:

Women with a history of the following cases during a previous pregnancy may be classified under BOH:

• Intrauterine demise: The mother loses the baby in the uterus.
• Repeated abortions, especially in the first or the second trimester.
• Preterm labour.
• Anomalies in the foetus.
• Neonatal demise: Which is the death of a new-born baby within a month.
• Severe intrauterine growth restriction (IUGR) or foetal growth restriction.

What causes BOH:

There are multiple causes which can lead to BOH. Some of the common causes are:

• Genetic causes: genetic reasons are one of the most common causes of BOH. Genetic reasons often lead to habitual abortions, especially during the first or the second trimester.
• Conditions like thyroid dysfunction during pregnancy may also be a factor of BOH.
• Anatomical factors related to the uterus or the cervix.
• Infections can also cause BOH.
• Pre-eclampsia, which is a condition characterised by high blood pressure in women.
• Acquired or inherited thrombophilia.

Identifying the root cause of BOH is extremely important to take appropriate steps to minimize the risk.

Management and treatment:

The treatment method adopted for BOH mostly depends on the cause of BOH. Some commonly adopted treatment procedures are:

• Karyotype analysis: It is done in case of habitual abortions. Karyotype analysis involves evaluating the number and structure of chromosomes to detect abnormalities. In cases of habitual abortions, the karyotype analysis is done for both the parents as well as the aborted foetus.
• If the BOH is due to endocrine causes, doctors monitor the levels of prolactin, Thyroid Stimulating Hormone (TSH), and anti-thyroid antibodies in the body.
• In cases of infections, the TORCH test is usually done to screen for the presence of various antibodies which may be causing BOH.

At Motherhood Hospitals, we understand how difficult pregnancy can be for someone with a bad obstetric history. Our experts are well-trained and have many years of experience in enabling patients with BOH to successfully deliver healthy babies. We also have state-of-the-art infrastructure to provide you with the best possible treatment and care.