Examination of women with miscarriage begins with a general examination, pay attention to the growth and body weight, the nature of the build, the severity of secondary sexual characteristics, the presence and nature of obesity, hirsutism, the presence of streaks on the skin (striae).
It should be noted that in the literature there is often an opinion that it is not necessary to carry out a survey due to habitual miscarriage, as every couple has a 60% chance of communicating a pregnancy without examination and treatment, and only 40% of it is lost again.
To determine the characteristics of the menstrual cycle and endocrine influences, studies are conducted using functional diagnostic tests. Currently, only the basal temperature record is used from all tests.
The goal of hormonal studies in patients with habitual miscarriage is to determine the causes of NLF formation, the severity of hormonal disorders for the selection of adequate therapy.
If there is an abortion in the anamnesis in the early periods, stillbirths of unknown origin, malformations of the fetus, it is advisable to carry out a genetic examination of the couple in the conditions of medical genetic counseling or a specialized laboratory.
Analysis of literature data and work experience of the department allows to draw a conclusion about the high importance of bacteriological and virological examination of patients with habitual miscarriages.
Indications for immunological examination: habitual miscarriage of pregnancy of unknown origin; anembrion in the anamnesis; previous pregnancy with a delay in intrauterine development; intrauterine fetal death at any stage of pregnancy; autoimmune diseases and conditions.
Hemostasiogram studies are the main test for the detection of autoimmune disorders. At present, the spectrum of haemostasis studies is quite wide, but the interpretation of the revealed violations can be complicated.
Currently, the most significant non-invasive method of research in obstetrics and gynecology is ultrasound. For the visualization of congenital malformations of the uterus, the second phase of the menstrual cycle is more informative, when the endometrium in the phase of secretion clearly delineates the contours of the uterine cavity.
According to the tests of functional diagnostics, an inferior luteal phase is revealed. Infection, as the cause of chronic endometritis, in which there may be an inferior luteal phase, is excluded. There are no intrauterine synechias, but there may be uterine hypoplasia, genital infantilism and malformations of the uterus without ischemic-cervical insufficiency.