Quenby and Farquharson developed a score for predicting a successful pregnancy in a woman with recurrent miscarriages. This can help determine if the woman requires counseling versus a more intensive evaluation. The authors are from Women's Hospital in Liverpool, England.
Parameters:
(1) age of the woman
(2) menstrual cycle
(3) history of previous live birth
(4) number of previous miscarriages
(5) presence of anticardiolipin antibodies
|
Parameter
|
Finding
|
Points
|
|
age of the woman
|
< 26 years
|
90
|
|
|
26 – 30 years
|
87
|
|
|
> 30 years
|
68
|
|
menstrual cycle
|
regular
|
87
|
|
|
oligomenorrhea
|
64
|
|
previous live birth
|
yes
|
87
|
|
|
no
|
74
|
|
number of previous miscarriages
|
2 or 3
|
88
|
|
|
4
|
64
|
|
|
> 4
|
40
|
|
anticardiolipin antibodies
|
present
|
72
|
|
|
absent
|
78
|
For each parameter:
final points =
= (points for finding) * (relative weighting factor)
total score =
= SUM(final points) =
= (3 * (points for age)) + (10 * (points for menstrual cycle)) + (points for previous live birth) + (4 * (points for previous miscarriage)) + (2 * (points for anticardiolipin antibodies))
where:
• Numeric values in the equation are the relative weighting factors.
• It appears as if the equation does not apply to a woman with only 1 previous miscarriage.
• I am uncertain if the number of previous miscarriages includes the most recent one. In the implementation I assumed that it did.
• I am not sure how a woman with irregular menses who is not oligomenorrheic would be scored. In the implementation I have assigned points as if the woman was oligomenorrheic or not (given the "regular" points). This may not be optimum.
percent success rate in a future pregnancy =
= (total score) / 20
Interpretation:
• maximum total score 1,735, giving a success rate of about 87%
• minimum total score 1,222, giving a success rate of about 61%
• A higher score indicates lower risk of miscarriage.
• Some women with recurrent miscarriage were found to have an isolated deficiency of estradiol in the luteal phase of the menstrual cycle. This could result in an inadequately developed endometrium with poor implantation of a fertilized ovum.
