Examination stages:
1. Anamnesis - collection of information. Risk groups for preterm birth include:
• women with a history of preterm labor in the absence of symptoms;
• women who have a shortening of the cervix less than 25 mm are detected during transvaginal examination;
• women who have a history of premature birth, who have lost 2 or more pregnancies;
• pregnant women who had a threat of miscarriage, spotting and retrochorial hematoma in the early stages.
2. An objective examination - an examination is performed, weight, height are measured.
3. Gynecological examination, flora smear, cytology smear, colposcopy.
4. Ultrasound of the pelvic organs. During pregnancy, the threat of loss is evidenced by: shortening of the cervix to 25 mm or less according to transvaginal cervicometry in the period of 17-24 weeks. The length of the cervix is clearly correlated with the risk of preterm birth, this is one of the prognostic signs of preterm birth. Transvaginal ultrasound measurement of the length of the cervix is a necessary standard in risk groups for miscarriage.
5. Examination for infections (sexually transmitted diseases, TORCH infections, HIV, hepatitis B and C, syphilis).
6. Hormonal screening:
• on the 2nd-5th day of the menstrual cycle with a regular cycle or in the absence of menstruation any day in the morning on an empty stomach;
• Prolactin, FSH (follicle-stimulating hormone), LH (luteinizing hormone), TSH (thyroid-stimulating hormone), estradiol, free testosterone, DGA-sulfate, cortisol are determined.
7. Ultrasound of the mammary glands.
8. Ultrasound of the thyroid gland and adrenal glands.
According to indications: hysterosalpingography, hysteroscopy, laparoscopy, CT or MRI of the skull and sella turcica, spiral CT of the pelvis / MRI.
Examination of a man:
1. Consultation with an andrologist - a male doctor who specializes in diseases of the male genitourinary system. Often, miscarriage is associated with a male factor in the form of chronic inflammatory diseases of the genitourinary system of a man, the carriage of STDs, and abnormalities in the spermogram.
2. Spermogram + MAR test. The MAR test is a study aimed at detecting antisperm antibodies of the IgG and IgA classes for diagnosing the immunological causes of infertility in men. The MAR test shows the ratio (percentage) of normal, actively motile spermatozoa coated with antisperm antibodies to the total number of spermatozoa with the same characteristics. It also allows you to estimate the percentage of spermatozoa excluded from fertilization. A positive MAR test is a conditional criterion for immunological infertility in men (more than 50%). It is important to remember the rules for taking a spermogram: do not drink alcoholic beverages for 3-5 days, refrain from sexual intercourse, do not visit saunas and baths.
3. Infectious screening.