Section 2

Practical Approaches to the Prediction, Prevention, and Treatment of Spontaneous Abortions

*Induced Abortion and Spontaneous Early Pregnancy Loss - Focus on Management*

A cross-sectional multicentre study. The European Journal of Contraception

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**43**

**Chapter 4**

**Abstract**

**1. Introduction**

the embryo and the endometrium.

Implantation and the Fetal Health

Implantation is one of the crucial periods in human reproduction. Increasing body of evidence suggests that the improper (dysfunctional) implantation and the formation of the placenta can endanger life and health of both the fetus and the mother, during prenatal life and decades after delivery. The idea of the inverted pyramid of prenatal care has emerged in the recent years, as the early detection and prevention of health disorders of the fetus are specially focusing on the first trimester. By applying this principle, disorders in the perinatal period could be prevented or treated with better outcome. The changes that lead to the deficient implantation should be sought in the preimplantation period, in relation between the embryo and the endometrium. It is possible that the time is approaching when the disorders of the pregnancy caused by dysfunctional implantation would be the indication for the application of a natural IVF (without ovarian stimulation) with the use of new biotechnological achievements. For better results of the perinatal medicine, it is necessary to apply earlier (in the preconception and preimplantation periods) the therapy based on the subcellular

Most of the fetal and maternal complications become apparent with advancing gestation. However, since very important complications that occur later in pregnancy can be predicted in the first trimester, the focus has been set on the evaluations in early pregnancy, thus inverting the pyramid of prenatal care. Although vast majority of early screening tests have been developed and employed, the outcome of pregnancies with the major obstetric syndromes still fails to be significantly improved. The changes etiologically and pathophysiologically associated with disturbed placentation and responsible for the perinatal mortality and morbidity should be sought even earlier, in the preimplantation period, in relation between

The idea of inverted pyramid of prenatal care has emerged for the purpose of prediction and prevention and then early detection and treatment of health disorders of the fetus. By applying this principle, a number of disorders could be prevented or treated with better outcome: fetal aneuploidy and anomalies, miscarriage,

*Aleksandar Ljubic, Dzihan Abazovic, Dusica Ljubic,* 

and genetic level by applying the latest biotechnological procedures.

**Keywords:** implantation, fetal health, pregnancy complications

**2. Early pregnancy screening tests and algorithms**

*Andrea Pirkovic and Andjela Perovic*
