Recurrent Miscarriage Panel (BOH Panel), with Karyotyping Test
Recurrent Miscarriage Panel (BOH Panel), with Karyotyping Test
When women undergo more than two miscarriages, before the first trimester, it is called a recurrent miscarriage. Many factors affect pregnancy. Hormonal imbalances, especially the ones that help maintain the pregnancy or foetus development, genetic abnormalities which causes blood clotting disorders in the mother, or other autoimmune disorders (immune system attacking the body’s healthy cells) can cause recurrent miscarriages. If the foetus has genetic abnormalities, that can cause miscarriage too. Karyotyping is a way to assess the genetic make-up of a cell to ensure that there are no genetic abnormalities. This panel test is done to help identify the reasons for the repeated miscarriages.
What is the Recurrent Miscarriage Panel (BOH Panel), with Karyotyping test Used For?
Recurrent Miscarriage Panel (BOH Panel), with Karyotyping test can help identify why recurrent miscarriages occur. People who have suffered two or more miscarriages should undergo this test. Parents should also undergo karyotyping to see if there are no genetic abnormalities in their cells, which when passed on to the foetus, may cause abnormal number of chromosomes, resulting in miscarriages. Women at risk of miscarriages due to other reasons may also undergo this test.
Symptoms of Miscarriage and Complications
Some of the symptoms of miscarriages are
Spotting (light bleeding)
Lower back cramps
Releasing tissue or fluid from the vagina
Higher heart rate
Which Tests are Included in Recurrent Miscarriage Panel (BOH Panel), with Karyotyping Test?
ANA by IFA
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Presence of Antinuclear Antibodies (ANA) is checked by indirect fluorescence antibody method. This test can indicate if the mother has any autoimmune disorders.
TSH Test
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TSH or Thyroid stimulating hormone, influences the thyroid glands to make other thyroid hormones. Fluctuations in TSH, would affect thyroid function, which can also affect the development of the foetus.
Antiphospholipid IgG and IgM levels
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This test checks for the levels of antiphospholipid antibodies that can indicate issues with regulating blood clotting creating complications in the pregnancy.
Cardiolipin Antibodies
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These are also a type of antiphospholipid antibodies. Abnormal levels of these antibodies indicate the possibility of blood clotting disorders.
Lupus Anticoagulant Values
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Abnormal levels of Lupus antibodies, another type of antiphospholipid antibodies, may cause blood clotting disorders. This test is done by comparing the time required for blood to clot on its own (prothrombin time or PT) and the time required for blood to clot when chemicals that accelerate the clotting are added (aPTT or activated partial Thromboplastin time) with control values (normal time required for clotting).
Karyotyping
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It is a method of examining the genetic material or DNA, which are organised in the form of chromosomes. We usually have 23 pairs of chromosomes (46 chromosomes, one set each from a parent). If there are deletions or repetitions in the chromosomes, it can cause complications in pregnancy and the foetus itself. This test examines for abnormalities in the chromosomes of the tissues of the foetus or of the parents.
Preparation for Test
Before the test, let your general physician know of any medication, supplements or treatments that you are taking or undergoing. Before submitting the blood sample, ensure that you have not been drinking alcohol or other intoxicants as this may affect the results. There are no other special preparations for this test, unless told by the physician.
Interpretation of Test Results
ANA by IFA: Abnormal levels of ANA may indicate towards presence of autoimmune disorders. A value of less than or equal to 1.0 unit is a negative test. More than 3.0 units indicates towards positive test.
TSH Test: During the first trimester in pregnancy, reference value or normal range of the TSH is 0.1-2.5 mIU per litre. Having values outside of this range may indicate a positive result, which would mean the levels of this hormone are not appropriate for the normal development of the foetus.
Antiphospholipid IgG and IgM levels, Cardiolipin Antibodies, Lupus Anticoagulant Values: These tests look for blood clotting disorders due to antiphospholipid syndrome in the mother.
For Antiphospholipid IgG and IgM levels and Cardiolipin antibodies, where MPL or GPL means presence of 1 microgram of IgM (MPL) or IgG antibody (GPL). Having more than 40 MPL or GPL may mean presence of antiphospholipid syndrome, and a positive test. This is done at least twice, before and after 12 weeks. Having less than 15.0 MPL/GPL may indicate a negative test, which means that it is unlikely that you have antiphospholipid syndrome. But this test should also correlate with Lupus anticoagulant value test.
Lupus Anticoagulant Value: Reference value for Prothrombin Time (PT) is 9.4-12.5 seconds and for activated Partial Thromboplastin Time (aPTT) is 25-37 seconds. If the values remain within this reference range, it indicates a negative test. A value more than this is considered as a positive test, and other confirmatory tests are done. A positive test would mean that there is a possibility of blood clotting disorder in the mother.
Karyotyping: Presence of abnormal chromosomes (presence of triple chromosomes instead of a pair or trisomy) in the foetus tissue or deletions and inversions in the chromosomes of the parents, would lead to difficulties in sustaining pregnancy. Presence of such abnormalities indicates a positive test, and absence of these abnormalities would mean a negative test
FAQs
How is the sample collected for the Recurrent Miscarriage Panel (BOH Panel), with Karyotyping test?
A blood sample is collected from a vein in your arm. If the tissue of the miscarried foetus is available, it is submitted to the diagnostic laboratory. In case, foetus tissue sample is not available, the blood from the parents are collected for karyotyping.
What is the turnaround time (TAT) for Recurrent Miscarriage Panel (BOH Panel), with Karyotyping test?
The tests results should come within 5-6 days after the sample is taken. This time would depend on the diagnostic laboratory that has taken the sample for analysis.
What should we do if we have Recurrent Miscarriage?
In case, there have been more than two miscarriages, contact your physician, who would order the BOH panel. Karyotyping is also done to see if there are genetic issues that are interfering with pregnancy. They may also check the uterus via imaging studies, for the presence of polyps and fibroids, which also might interfere.
Can we prevent miscarriages?
Miscarriages happen mostly due to random reasons. There is no way to prevent miscarriages. If some early sign of miscarriage is being observed like spotting (very light bleeding), doctor may ask you to rest. Maintaining a healthy lifestyle, limiting intake of caffeine, alcohol and other addictive substances along with maintaining a healthy weight may help.
Who is at risk of recurrent miscarriages?
People who are above the age of 35, having had a history of miscarriage due to abnormal genetic make-up of the foetus, are at a higher risk of recurrent miscarriages. But this does not mean that healthy pregnancy is not possible. Addressing underlying issues and with the help of doctors monitoring regularly, genetic counselling and other measures, a healthy pregnancy is possible.
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