Recurrent pregnancy lossHistorically, 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:
- Embryonic heart activity observed before any earlier pregnancy loss.
- Normal karyotype of products on conception from an earlier loss.
- Female partner age over 35 years.
Most common cause of recurrent abortions:
- Genetic factor/defective germplasm.
- Most common type of chromosomal abnormality is balanced translocation.
- Cervical incompetence
TORCH infection not a cause.
Investigation in case of RPL:
- Parental peripheral blood karyotyping with banding technique.
- Hysteroscopy and HSG
- Thyroid function test, serum prolactin
- Anticardiolipin antibody and lupus anticoagulant testing.
- Complete blood counts with platelet count.
- Thrombophilia testing:
- Protein C and antithrombin activity.
Investigation not done in RPL:
- Blood glucose