BAD OBSTETRIC HISTORY (BOH) BASIC
BAD OBSTETRIC HISTORY (BOH) BASIC
Bad obstetric history (BOH) refers to a comprehensive assessment of a woman's obstetric history, focusing on past pregnancies, deliveries, and complications. It includes factors like recurrent miscarriages, stillbirths, preterm deliveries, neonatal deaths, and any maternal health issues. BOH basic aids in identifying potential risks and providing appropriate management strategies for current and future pregnancies. It helps healthcare professionals tailor personalized care plans, optimize maternal and fetal outcomes, and prevent complications.
Thus, getting this panel is recommended to identify the underlying cause behind repeated miscarriages
Which tests are included?
The BOH basic panel is used to evaluate:
1. Anti-nuclear antibodies (ANAs): ANAs are antibodies that target healthy and typical proteins in the nucleus of a cell. The healthy fetus is attacked by these ANAs causing unfavorable pregnancy outcomes. BOH basic panel aids in the diagnosis of several autoimmune disorders that may affect the developing fetus.These disorders include autoimmune hepatitis, systemic lupus erythematosus (SLE), scleroderma, and Sjögren's syndrome.
2. Anti-phospholipid antibodies (APAs): APAs assist in the process of blood clotting in pregnant women. Women who have antiphospholipid antibodies in their bodies experience repeated miscarriages because the placenta cannot receive enough blood, which affects the fetus's ability to receive the required supply of oxygen, nutrients, and blood.
APAs are found in about 15-20% of pregnant women who experience recurrent miscarriages. BOH basic panel includes the detection of antibodies like lupus anticoagulant (LA), anticardiolipin antibodies (ACAs), and anti-beta-2-glycoprotein I antibodies (AB2GPI).
3. TORCH infections: Toxoplasmosis, syphilis, hepatitis B, rubella, cytomegalovirus, and herpes are all included in the group of infections known as TORCH. These infections are all harmful to the developing fetus. BOH basic panel involves the detection of a group of infections that may pass down from an infected mother to her developing or newborn baby.
4. Thyroid hormone test: Hypothyroidism can increase the risk of miscarriages in the second trimester. The BOH basic panel measures the levels of various hormones such as thyroxine (T4), triiodothyronine (T3), and thyroid stimulating hormone (TSH).
Symptoms of recurrent pregnancy loss
Each miscarriage is unique, as are the symptoms that accompany it. While one person might bleed and experience pain, the other person might have no symptoms at all
Spotting or bleeding
Back pain (mild to severe)
White pink mucus discharge from the vagina
Painful contractions
Tissue resembling a clot passing through the vagina
No longer experiencing pregnancy symptoms
Who should get tested?
The BOH basic panel is indicated for:
Women who are trying to get pregnant after turning 40
People who find it difficult to conceive after 1 year of unprotected sex
Family history of infertility
Past history of two or more recurrent miscarriages
Family history of recurrent miscarriage
Recurrent miscarriages while undergoing IVF
Pregnant women who have untreated medical conditions such as diabetes, thyroid, etc.
Test preparation
No special preparation is required. Certain medicines (hormonal supplements) may affect the results of this panel, therefore ask your doctor for details about pre-test preparations, and make sure to follow instructions closely
Interpretation of the Test Results
|
Results |
Inference |
|
|
Antiphospholipid antibodies |
< 12 units per millilitre
>18 units per millilitre |
Positive: Antibodies are detected Negative: No antibodies are detected |
|
Antinuclear antibodies (titre ratio) |
>1:160
<1:160 |
Positive: Antibodies are detected Negative: No antibodies are detected |
|
TORCH infections |
Presence of IgG and IgM antibodies
Absence of IgG and IgM antibodies |
Positive: Indicates the presence of infection Negative: No infection detected |
|
Thyroid panel |
Normal TSH and lower T3 and T4
Normal TSH and higher T3 and T4 |
Hypothyroidism
Hyperthyroidism |
Note: A positive test result in ANA does not always lead to a conclusive diagnosis. Further antibody testing is essential to identify illnesses such as autoimmune hepatitis, hepatitis C, HIV, etc
FAQs
What happens during the BOH basic panel?
Your healthcare provider will use a tiny needle to take blood from a vein in your arm. After the needle is placed, a small amount of blood will be collected into a test tube or vial. This procedure usually takes less than few a minutes
What are the risks associated with the BOH basic panel?
The BOH basic panel poses minimal risk. You may experience slight discomfort or bruising at the site where the blood was drawn, but these symptoms will subside quickly. In rare cases, there is a possibility of infection occurring at the site
What is the turnaround time (TAT) for the results of the BOH basic panel?
The BOH basic panel results are usually available within 3 working days after the sample collection. This duration may vary depending on the diagnostic clinic
What are the various causes of recurrent pregnancy loss?
Recurrent pregnancy loss can occur from a variety of factors including genetic abnormalities in the embryo, hormonal imbalances, uterine abnormalities such as fibroids, autoimmune disorders, blood clotting disorders, infections, lifestyle factors like smoking or excessive alcohol consumption, advanced maternal age, and environmental factors. Psychological stress may also play a role. Proper diagnosis to address underlying issues is necessary to improve the chances of a successful pregnancy
I had a miscarriage lately. How long should I wait to try again?
It is always preferable to give your body some time to heal emotionally and physically after a miscarriage before considering getting pregnant again. After one miscarriage, there might be no need to wait to conceive. However, it is usually recommended to wait three months for the uterus to heal and resume normal period cycles. Talk to your doctor and also consider getting a full body check-up
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