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An Automated System for Early Prediction of miscarriage in the First Trimester Using Machine Learning

Computers, Materials & Continua 2023年第4期75卷 1291-1304页

作者： Sumayh S.Aljameel Malak Aljabri Nida Aslam Dorieh M.Alomari Arwa Alyahya Shaykhah Alfaris Maha Balharith Hiessa Abahussain Dana Boujlea Eman S.Alsulmi Department of Computer Science College of Computer Science and Information TechnologyImam Abdulrahman Bin Faisal UniversityP.O.Box 1982Dammam31441Saudi Arabia Computer Science Department College of Computer and Information SystemsUmm Al-Qura UniversityMakkah21955Saudi Arabia Department of Computer Engineering College of Computer Science and Information TechnologyImam Abdulrahman Bin Faisal UniversityP.O.Box 1982Dammam31441Saudi Arabia Department of Obstetrics and Gynecology College of MedicineImam Abdulrahman Bin Faisal UniversityDammamSaudi Arabia

Currently, the risk factors of pregnancy loss are increasing andare considered a major challenge because they vary between cases. The earlyprediction of miscarriage can help pregnant ladies to take the needed careand avoid any danger. Therefore, an intelligent automated solution must bedeveloped to predict the risk factors for pregnancy loss at an early stage toassist with accurate and effective diagnosis. Machine learning (ML)-baseddecision support systems are increasingly used in the healthcare sector andhave achieved notable performance and objectiveness in disease predictionand prognosis. Thus, we developed a model to help obstetricians predictthe probability of miscarriage using ML. And support their decisions andexpectations about pregnancy status by providing an easy, automated way topredict miscarriage at early stages using ML tools and techniques. Althoughmany published papers proposed similar models, none of them used Saudiclinical data. Our proposed solution used ML classification algorithms tobuild a miscarriage prediction model. Four classifiers were used in this study:decision tree (DT), random forest (RF), k-nearest neighbor (KNN), andgradient boosting (GB). Accuracy, Precision, Recall, F1-score, and receiveroperating characteristic area under the curve (ROC-AUC) were used to evaluatethe proposed model. The results showed that GB overperformed the otherclassifiers with an accuracy of 93.4% and ROC-AUC of 97%. This proposedmodel can assist in the early identification of at-risk pregnant women to avoidmiscarriage in the first trimester and will improve the healthcare sector inSaudi Arabia.

关键词： miscarriage pregnancy abortion machine learning gradient boosting

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A comparison of implantation, miscarriage and pregnancy rates of single and double day 3 embryo transfer between fresh and frozen thawed transfer cycles： a retrospective study

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Chinese Medical Journal 2014年第5期127卷 911-915页

作者： Liu Liu Tong Xiaomei Jiang Lingying Tinchiu Li Zhou Feng Zhang Songying Center of Reproductive Medicine Sir Run Run Shaw HospitalSchool of Medicine Zhejiang University Hangzhou Zhejiang 310006 China Department of Reproductive Medicine Jessop Wing Royal Hallamshire Hospital University of Sheffield UK

Background Reduced endometrial receptivity in hyperstimulated cycles may lead to a lower implantation rate and a lower clinical pregnancy rate,but it is unclear if it is also associated with an increase in pregnancy loss rate.The aim of this study was to compare the implantation,miscarriage,and pregnancy rates between fresh and frozen thawed transfer of one or two day-3 embryos,with a view to understanding whether or not reduced endometrial receptivity encountered in hyperstimulated cycles is associated with an increase in miscarriage rate.Methods This study involved a consecutive series of 1 551 single day-3 embryo transfer cycles and consecutive 5 919 double day-3 embryo transfer cycles in the Assisted Reproductive Unit of the Sir Run Run Shaw Hospital,Hangzhou,China,between January 2010 and December 2012.Results The implantation and clinical pregnancy rates （single embryo 30.7％ and double embryos 33.4％ and 51.4％）using fresh cycle were both significantly lower than that of frozen-thawed cycles （single embryo 35.8％ and double embryos 38.1％ and 57.8％）.There was no difference in biochemical loss or clinical miscarriage rates between the two groups.Conclusions Impairment of endometrial receptivity associated with ovarian hyperstimulation leads to implantation failure at a very early stage,resulting in an increased number of non-pregnancy.It does not lead to increase in biochemical or clinical losses.The significantly reduced ongoing pregnancy rates in both fresh single and double embryo transfer are therefore due to failure to achieve a pregnancy,rather than pregnancy loss after conception.

关键词： pregnancy loss miscarriage in vitro fertilization embryo transfer implantation rate

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Aneuploidy in Early miscarriage and its Related Factors

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Chinese Medical Journal 2015年第20期128卷 2772-2776页

作者： Chan-Wei Jia Li Wang Yong-Lian Lan Rui Song Li-Yin Zhou Lan Yu Yang Yang Yu Liang Ying Li Yan-Min Ma Shu-Yu Wang Department of Reproduction Beijing Obstetrics and Gynecology Hospital Capital Medical University Beijing 100026 China

Background： Genetic factors are the main cause of early miscarriage. This study aimed to investigate aneuploidy in spontaneous abortion by fluorescence in situ hybridization （FISH） using probes for 13, 16, 18, 21, 22, X and Y chromosomes. Methods： A total of 840 chorionic samples from spontaneous abortion were collected and examined by FISH. We analyzed the incidence and type of abnormal cases and sex ratio in the samples. We also analyzed the relationship between the rate of aneuploidy and parental age, the rate of aneuploidy between recurrent abortion and sporadic abortion, the difference in incidence of aneuploidy between samples from previous artificial abortion and those from no previous induced abortion. Results： A total of 832 samples were finally analyzed. 368 （44.23%） were abnormal, in which 84.24% （310/368） were aneuploidies and 15.76% （58/368） were polyploidies. The first was trisomyl6 （121/310）, followed by trisomy 22, and X monosomy. There was no significant difference in the rate ofaneuploidy in the advanced maternal age group （≥35 years old） and young maternal age group （〈35 years old）. However, the rate oftrisomy 22 and the total rate of trisomies 21, 13, and 18 （the number oftrisomy 21 plus trisomy 13 and trisomy 18 together） showed significantly different in two groups. We found no skewed sex ratio. There was no significant difference in the rate of aneuploidy between recurrent miscarriage and sporadic abortion or between the samples fi＇om previous artificial abortion and those from no previous artificial abortion. Conclusions： Aneuploidy is a principal factor of miscarriage and total parental age is a risk factor. There is no skewed sex ratio in spontaneous abortion. There is also no difference in the rate of aneuploidy between recurrent abortion and sporadic abortion or between previous artificial abortion and no previous induced abortion.

关键词： Aneuploidy Artificial Abortion In Situ Hybridization miscarriage Parental Age Recurrent Abortion Sex Ratio

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Relationship between expression of COX-2,TNF-α,IL-6 and autoimmune-type recurrent miscarriage

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Asian Pacific Journal of Tropical Medicine 2013年第12期6卷 990-994页

作者： Fu Hua Chang-Hua Li Hong Wang Hong-Ge Xu Department of Gynaecology and Obstetrics Huai'an First People's HospitalNanjing Medical University

Objective:To investigate the roles of COX-2,TNF-α,IL-6 in the pathogenesis of autoimmunetype recurrent spontaneous abortion(RSA).Methods:RT-PCR was used to detect the mRNA of COX-2,TNF-α.IL-6 in the trophoblast cells of murine RSA and normal pregnant models.The COX-2,TNF-α.IL-6 protein expressions were determined by using immunohistochemisry staining method.The COX-2,TNF-α,IL-6 protein expressions were determined by ELISA.Results:The embryo loss rates in experiment group was significantly higher than that in normal pregnancy control group,the expression of COX-2,TNF-α,IL-6 in the trophoblast cells of murine RSA and normal pregnant models.The expression of COX-2 in autoimmunetype recurrent spontaneous abortion was significantly lesser than in normal pregnant models.The expression of TNF-α,IL-6 in autoimmune-type recurrent spontaneous abortion was significantly higher than in normal pregnant models.There was a positively correlation between TNF-αand IL-6.There was no relationship between COX-2,TNF-αand IL-6.Conclusions:The abnormal expression of COX-2,TNF-αand IL-6 may result in RSA.

关键词： Autoimmune Recurrent miscarriage Animal model Maternal-fetal interface

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Meta-analysis of aspirin-heparin therapy for un-explained recurrent miscarriage

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中国医学科学杂志：英文版 2016年第4期31卷 239-246页

作者： Ling Tong Xian-jiang Wei Department of Gynaecology and Obstetrics XiXi Hospital of Hangzhou Department of Gynaecology and Obstetrics Hangzhou Red Cross Hospital

Objective This study was designed to evaluate the efficacy and safety of aspirin-heparin treatment for un-explained recurrent spontaneous abortion(URSA). Methods Literatures reporting the studies on the aspirin-heparin treatment of un-explained recurrent miscarriage with randomized controlled trials(RCTs) were collected from the major publication databases. The live birth rate was used as primary indicator, preterm delivery, preeclampsia, intrauterine growth restriction, and adverse reactions(thrombocytopenia) were used as the secondary indicators. The quality of the included studies was evaluated using RCT bias risk assessment tool in the Cochrane Handbook(v5.1.0). Meta-analysis was conducted using RevM an(v5.3) software. Subgroup analyses were conducted with an appropriately combined model according to the type of the treatments if heterogeneity among the selected studies was detected. Results Six publications of RCTs were included in this study. There were a total of 907 pregnant women with diagnosis of URSA, 367 of them were pooled in the study group with aspirin-heparin therapy and 540 women in the control group with placebo, aspirin or progesterone therapy. Meta-analysis showed that the live birth rate in the study group was significantly different from that in the control group [RR = 1.18, 95% CI(1.00-1.39), P=0.04]. Considering the clinical heterogeneity among the six studies, subgroup analysis were performed. Live birth rates in the aspirin-heparin treated groups and placebo groups were compared and no significant difference was found. There were no significant differences found between the two groups in the incidence of preterm delivery [RR=1.22, 95% CI(0.54-2.76), P=0.64], preeclampsia [RR=0.52, 95% CI(0.25-1.07), P=0.08], intrauterine growth restriction [RR=1.19, 95% CI(0.56-2.52), P=0.45] and thrombocytopenia [RR=1.17, 95% CI(0.09-14.42), P=0.90]. Conclusion This meta-analysis did not provide evidence that aspirin-heparin therapy had beneficial effect on un-explained recurrent miscarriage in terms of

关键词： recurrent miscarriage aspirin heparin randomized controlled trials meta-analysis

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Primary biliary cholangitis in pregnancy:A systematic review with meta-analysis

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Hepatobiliary & Pancreatic Diseases International 2022年第3期21卷 218-225页

作者： Hydar El Jamaly Guy D Eslick Martin Weltman Department of Gastroenterology and Hepatology Nepean HospitalPenrithNew South WalesAustralia Nepean Clinical School The University of SydneyPenrithNew South WalesAustralia NHMRC Centre for Research Excellence in Digestive Health Hunter Medical Research InstituteThe University of NewcastleNewcastleNew South WalesAustralia

Background: The outcomes and disease associations in pregnant women with primary biliary cholangitis(PBC) have not been largely explored. This study aimed to determine the level of evidence associated with maternal and fetal outcomes and other disease associations in female patients with PBC. Data sources:: A comprehensive literature search was conducted. Maternal and fetal outcomes were obtained from patients with a previous, current or subsequent diagnosis of PBC. A random-effects model was employed, using odds ratios(ORs) with 95% confidence intervals(CIs). Results: Eleven studies, with 2179 female PBC patients were included. Pregnant women with PBC were significantly more likely to have a miscarriage(OR = 1.27, 95% CI: 1.02-1.58;P = 0.03), and a history of abortion(OR = 1.50, 95% CI: 1.09-2.07;P = 0.01), with absent heterogeneity( I 2 = 0%). PBC pregnant women were significantly more likely to deliver via vaginal birth(OR = 1.69, 95% CI: 1.33-2.14;P < 0.001) with low level heterogeneity( I^(2) < 0.001%). Patients had a statistically significant increased likelihood of lifetime smoking(OR = 1.95, 95% CI: 1.17-3.23;P = 0.01). Egger’s regression revealed no evidence of publication bias. Conclusions: This meta-analysis provides pooled evidence that a PBC pregnancy is associated with fetal morbidity and maternal lifestyle associations that may influence pregnancy outcomes. More studies are needed to establish disease associations that may directly affect pregnancy outcomes. These data are essential for clinicians managing these patients before, during or after pregnancy.

关键词： Pregnancy Fetal Maternal Primary biliary cholangitis miscarriage

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miscarriage—Evidence Based Information for the Web and Its Development Procedure

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Advances in Sexual Medicine 2015年第4期5卷 89-110页

作者： Annsofie Adolfsson Emelie Arbhede Elisabeth Marklund Per-Göran Larsson Marie Berg School of Health and Medical Sciences &Oumlrebro University &Oumlrebro Sweden The Centre for Women’s Family and Child Health Faculty of Health Sciences Buskerud & Vestfold University College Kongsberg Norway Department Obstetrics and Gynecology Ryhov County Hospital J&oumlnk&oumlping Sweden Women’s Clinic Highland Distric County Hospital Eksj&ouml Sweden Department of Obstetrics and Gynaecology University of Link&oumlping Link&oumlping Sweden Institutes of Health and Care Science Sahlgrenska Academy Gothenburg University Gothenburg Sweden Centre for Person-Centred Care (GPCC) University of Gothenburg Gothenburg Sweden

Objective: The aim of this paper is to describe the process of developing web information on miscarriage based on scientific evidence, for women and couples in Sweden experiencing miscarriage. Method: A participatory design was used which included researchers, professional experts and users. A participatory design was used involving researchers, professional experts and users. The information was developed in six stages: 1) identifying the needs of information;2) identifying and constructing the main areas of information and its paths;3) identifying and inviting experts for revision;4) developing the text;5) reviewing the text;6) design and structuring for adaption to website. Results: The text of information developed gradually based on the seven steps. The final text comprised three parts: 1) what is miscarriage;2) experiences of miscarriage;3) processing and planning for new pregnancy. Conclusion: Using participatory design was time and resource consuming, however it was functional for producing appropriate information for the target group. The developed evidence based facts text is assumed to be a complement to the information that is provided by the health care system.

关键词： miscarriage Evidence-Based Information Women Partner

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Recurrent miscarriage: Hysteroscopy-Assisted Management

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Open Journal of Obstetrics and Gynecology 2018年第5期8卷 425-430页

作者： Fady M. Shawky Moiety Abdel Fattah Agameya Hisham Aly Saleh Department of Obstetrics and Gynecology Faculty of Medicine Alexandria University Alexandria Egypt

Objective: To apply office hysteroscopy in assessment/management of patients with recurrent miscarriage, thus to/or not to recommend office hysteroscopy as a routine procedure in such cases. Study design: Retrospective analysis. Setting: University hospital’s outpatient abortion clinic. Subjects & Methodology: Patients’ records during the period between March 2015 and January 2017 for subjects with at least 2 previous miscarriages, who had undergone office hysteroscopy were reviewed. Results: Cases with 2 previous miscarriages (n = 95) were assessed and compared with those with 3 or more miscarriages (n = 105). Abnormal uterine findings were diagnosed in 24.1% of the former, and 43.8% of the latter group. The prevalence of uterine lesions among cases with 2 recurrent miscarriages was 42.1%;meanwhile, for subjects with 3 or more consecutive miscarriages, it was 43.8%. Conclusion: In addition to safety profile, simplicity and outpatient basis of use, outpatient hysteroscopy in recurrent miscarriages would be an added-value to practitioners as a diagnostic and therapeutic tool.

关键词： Hysteroscopy Office Recurrent miscarriage

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Predicting adverse maternal and perinatal outcome after threatened miscarriage

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Open Journal of Obstetrics and Gynecology 2014年第1期4卷 1-7页

作者： Swati Agrawal Susheela Khoiwal Kumar Jayant Rajendra Agarwal Obs & Gynae Rabindra Nath Tagore Medical College Udaipur India Postgradute Institute & Medical Research Centre Chandigarh India Sudha Hospital and Medical Research Institute 11-A Talwandi Kota India

Objectives: Threatened miscarriage is the most common complication of pregnancy, occurring in 20% - 25% of ongoing pregnancies. The purpose is to study maternal and perinatal outcome in women with threatened miscarriage. Methods: A prospective study was conducted over a period of 20 months in the Department of Obstetrics and Gynaecology, Pannadhay Mahila Chikitsalaya, a tertiary care center in Udaipur, India. It included a cohort of pregnant patients with a history of threatened miscarriage during the first twenty weeks of pregnancy. They were registered, followed up prospectively at antenatal clinics and delivered in the same hospital. For the purpose of comparison, another group of booked patients (controls) without a history of threatened miscarriage were recruited, similarly scanned and followed throughout pregnancy and labour. All women were matched for age, parity, social class, BMI and gestational age at booking. Discrete variables were taken as counts (or frequencies) and were evaluated by Chi-square test. Continuous variables with normal distribution were presented as mean ± standard deviation (SD) and were compared by unpaired Student’s t test. Data were fed into a Microsoft Excel worksheet and were analyzed by using the SPSS ver.17 (SPSS Inc., Chicago, IL, USA). p-value > 0.05 was considered statistically significant. Results: Out of 62 cases, 13 (21%) patients spontaneously aborted after diagnosis of threatened miscarriage. Women with threatened miscarriage had a significantly higher incidence of low lying placenta (p = 0.02) when compared with those without firsttrimester bleeding. They were more likely to experience PROM (p = 0.02), preterm delivery (p = 0.02) and to have babies with low Birthweight (p = 0.03). Conclusion: Pregnancies complicated by threatened miscarriage are at a higher risk for obstetric complications.

关键词： First-Trimester Bleeding Threatened miscarriage Maternal Outcome Perinatal Outcome Subchorionic Hematoma

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A Specific Pattern in the Basal Body Temperature Chart during the First Week of Pregnancy May Warn of a miscarriage Crisis

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Health 2016年第8期8卷 723-729页

作者： Mayumi Watanabe Yoshinobu Nakamura Chikako Tomiyama Toru Abo Department of Medical Informatics Niigata University Medical and Dental Hospital Niigata Japan Nakamura Seikotsuin Niigata Japan Department of Medical Technology Graduate School of Health Sciences Niigata University Niigata Japan Toru Abo Research Centre Niigata Japan

We studied the efficiency of acupuncture for patients who were unable to give birth though they had experienced conventional infertility treatment for more than 2 years by medical specialists. We then investigated characteristics of difficult pregnancy cases with measurement of body temperature and observation of basal body temperature (BBT) charts. Thirty-three patients had acupuncture every week for more than 2 years and 17 of them delivered. At the same time, their cutaneous body temperature was measured at five locations. Moreover, patients and acupuncturists had a weekly discussion of the patient’s BBT chart. The delivery group showed more balanced and higher cutaneous body temperatures than the miscarriage and no pregnancy groups. The delivery group showed a smooth increase in the BBT chart while the miscarriage group showed a specific pattern in shifting temperatures from low to high zones. Acupuncture might suppress excess sympathetic dominance, which induced hyperthermia as well as interruption of pregnancy. Additionally, weekly discussion and medical advice could help patients. However, further study of males, healthy women, or larger, comparative studies exploring the social and cultural background of other countries were needed to add support to these factors.

关键词： Basal Body Temperature (BBT) Chart miscarriage Kyusaku Ogino Acupuncture Medical Advice

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