Bleed

Recurrent Miscarriage

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Recurrent Miscarriage, Recurrent Pregnancy Loss

  • Indications for Recurrent Miscarriage evaluation
  1. Three consecutive Miscarriages
  • Causes (Idiopathic in up to 60% of cases)
  1. Recurrent first trimester pregnancy loss
    1. Chromosomal abnormality (5%)
    2. Antiphospholipid Antibody Syndrome (15%)
    3. Septate Uterus
    4. Polycystic Ovary Syndrome (40%)
  2. Recurrent Second Trimester Pregnancy Loss
    1. Chromosomal abnormality (5%)
    2. Antiphospholipid Antibody Syndrome (15%)
    3. Bicornuate Uterus
    4. Cervical incompetence (5%)
  • Management
  1. Preconception Counseling
    1. Folic Acid supplementation
    2. Rubella Vaccine
  2. Measures to be considered
    1. Low dose Aspirin
  3. Measures not found to be effective for prevention
    1. Lifestyle factors (e.g. strenuous activity)
    2. Progesterone
    3. Human chorionic gonadotropin
    4. Immunotherapy