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Recurrent pregnancy loss

Historically, recurrent pregnancy loss or "habitual abortion" was defined as 3 or more consecutive spontaneous miscarriages.



Today, recurrent pregnancy is usually defined as 3 or more pregnancy losses (not necessarily consecutive).


Most obstetricians also consider clinical investigation and treatment should be considered in couples with 2 consecutive spontaneous miscarriages, especially when any of the following are present:

  1. Embryonic heart activity observed before any earlier pregnancy loss.
  2. Normal karyotype of products on conception from an earlier loss.
  3. Female partner age over 35 years.
  4. Infertility.

Most common cause of recurrent abortions:


1st trimester

  • Genetic factor/defective germplasm.
  • Most common type of chromosomal abnormality is balanced translocation.

2nd trimester

  • Cervical incompetence

TORCH infection not a cause.

Investigation in case of RPL:

  1. Parental peripheral blood karyotyping with banding technique.
  2. Hysteroscopy and HSG
  3. Thyroid function test, serum prolactin
  4. Anticardiolipin antibody and lupus anticoagulant testing.
  5. Complete blood counts with platelet count.
  6. Thrombophilia testing:
    - Factor V leiden, prothrombin gene mutation, protein S activity.
    - Serum homocysteine level.
  7. Protein C and antithrombin activity.

Investigation not done in RPL:

  1. VDRL
  2. TORCH
  3. Blood glucose

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