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What is Bad Obstetric History (BOH) profile test?
Bad obstetric history (BOH) panel is classically defined as the loss of three consecutive pregnancies. A woman with any of the following experiences on two or more occasions is considered to have a BOH:
- Stillbirths (birth of a baby with no signs of life)
- Death of the baby within a month of birth
- Abnormalities in the baby present from birth
- Death of the baby in the womb
- Consecutive spontaneous miscarriages
- Intrauterine growth retardation
A bad obstetric history test is done to find out the underlying cause of the bad obstetric history in a woman.
Factors that are measured using this panel are as follows:
- Anti-phospholipid antibodies (APAs): These antibodies promote the coagulation of the blood, increasing the rate of blood clot formation in pregnant women. Blood clotting in the blood vessels of the placenta hampers the blood supply to the baby, which may result in miscarriage. About 15% of women with a recurrent miscarriage are found to have APAs, and the association between consecutive miscarriage and APAs is called an anti-phospholipid syndrome. The following are the main types of APAs:
- Lupus anticoagulant (LA): LA autoantibodies are of two main types, IgG and IgM. Both these predominant forms attack the phospholipid-protein on the surface of body cells. LA interferes with the blood clotting process and prolongs clotting time. It is mainly associated with bleeding and leads to complications like stroke, pregnancy loss and acquired thrombophilia (abnormal blood coagulation). LA is estimated to be present in approximately 2%-4% of the population; however, the true prevalence rate is still not clear. The incidence of LA increases with age.
- Anti-cardiolipin antibodies (ACA): IgG, IgA and IgM are the types of ACA antibodies that are formed in response to cardiolipins, which are fat-like substances in the blood. High levels of these antibodies are seen in women with repeated miscarriages. Therefore, it is a useful parameter in the BOH panel.
- Anti-β2 glycoprotein I antibodies: This test looks for the presence of antibodies against the β2 glycoprotein I in your blood. β2 glycoprotein I is a protein thbinds to certain molecules on the surface of body cells and is thought to prevent blood clotting. Presence of anti-β2 glycoprotein I antibodies may lead to premature births and increase the risk of miscarriage in pregnant women. Read more: Antiphospholipid antibody test
- Anti-nuclear antibodies (ANAs): As the name suggests, antinuclear antibodies attack the nucleus of a cell - nucleus is a tiny organelle present inside every cell of the body. These antibodies are of IgG, IgA and IgM type and are found circulating in the bloodstream of patients with certain disorders. Although the role of ANAs in miscarriages is not yet clear, they are known to be associated with recurrent miscarriage. Read more: Antinuclear antibody test
- TORCH infection: The major causes of BOH include infections caused by Toxoplasma gondii, rubella virus, cytomegalovirus and herpes simplex. TORCH panel test is a group of blood tests that aids in the detection of all four of these infections in pregnant women. The effects of these infections are mild on the mother; however, the baby might have serious complications. Also, these infections are more harmful to the foetus when they infect for the first time (primary infections) compared to when it is a recurrent infection. IgG and IgM antibodies for the TORCH infections are detected using a BOH panel.
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