Recurrent miscarriage: causes, evaluation and management

  title={Recurrent miscarriage: causes, evaluation and management},
  author={Carmen Garrido-Gimenez and Jaume Alijotas-Reig},
  journal={Postgraduate Medical Journal},
  pages={151 - 162}
Recurrent miscarriage is frustrating for the physician and a heartbreaking experience for the patient. Approximately 5% of couples trying to conceive have two consecutive miscarriages. Despite a thorough study of patients, the aetiology of this common obstetric complication is unknown in 50% of cases. Known causes include abnormal chromosomes, endocrinological disorders and uterine abnormalities. Although antiphospholipid antibodies have been demonstrated in miscarriages, the role played by… 

Overview on current approach on recurrent miscarriage and threatened miscarriage

This review presents available evidence-based guidance on the incidence, pathophysiology, investigation and clinical management of recurrent miscarriage and threatened miscarriage, focusing mainly on the fi rst trimester of pregnancy and primary healthcare settings.

Overview on current approach on recurrent miscarriage and threatened miscarriage

This review presents available evidence-based guidance on the incidence, pathophysiology, investigation and clinical management of recurrent miscarriage and threatened miscarriage, focusing mainly on the fi rst trimester of pregnancy and primary healthcare settings, to produce a concise answer for clinical practice.

Management of recurrent miscarriages: an overview of current evidence

In the majority of the cases no cause is identified, and the factors associated with RM may not be causally related with the condition, but a critical summary of the latest evidence for the investigation and management of women with RM is provided.

Aetiology of recurrent miscarriage and the role of adjuvant treatment in its management: a retrospective cohort review

  • S. DobsonK. Jayaprakasan
  • Medicine
    Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology
  • 2018
It is demonstrated that adjuvant treatments in unexplained RM have no significant benefit on future live birth rates, and high quality, prospective, randomised controlled trials looking at both adverse outcomes and benefits of adjUvant treatment in RM are needed.

Immunoglobulin G4 deficiency can be a new entity for primary recurrent miscarriage: Successful pregnancy in two cases after treatment with intravenous immunoglobulin

Two young women with recurrent miscarriage were consulted in the infertility center and the diagnosis of immunoglobulin G4 (IgG4) deficiency was made, and intravenous Ig 200 mg/kg was started monthly, and they both had successful pregnancies.

The Role of Uterine Natural Killer Cells on Recurrent Miscarriage and Recurrent Implantation Failure: From Pathophysiology to Treatment

Defining a causative relationship between uNK and RIF–RM pathologies certainly merits investigation and should serve as a prerequisite prior to proposing the use of uNK as a biomarker or prior to targeting uNK cells for therapeutic purposes addressing RIF and RM.

Unexplained Recurrent Miscarriage and Recurrent Implantation Failure: Is There a Place for Immunomodulation?

To describe and analyze the benefit of immunomodulatory drugs for recurrent miscarriages and implantation failures. The literature research was conducted in Medline, Embase and Cochrane Library

Endometrial Immune Dysfunction in Recurrent Pregnancy Loss

The present article reviews the major immunologic pathways, cells, and molecular determinants involved in the endometrial dysfunction observed with specific application to RPL, and suggests thatendometrial immune dysregulation could be responsible for several cases of RPL of unknown origin.

Active Immunisation with Partner Lymphocytes in Female Patients Who Want to Become Pregnant – Current Status

Immunisation with partner lymphocytes can be discussed with the couple on a case-by-case basis – provided that all other possible causes of sterility have been ruled out in advance, and represents a safe, low-risk procedure.

Does the number of previous miscarriages influence the incidence of chromosomal aberrations in spontaneous pregnancy loss?

  • M. GoldsteinR. SvirskyA. RechesY. Yaron
  • Medicine
    The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians
  • 2017
Evaluating factors that influence the frequency of chromosomal abnormalities in miscarriages and providing clinicians with a guideline for management of such cases did not find correlation between number of previous spontaneous miscarriages a women experienced and chromosomal aberration in her current miscarriage.



Current Concepts and New Trends in the Diagnosis and Management of Recurrent Miscarriage

Physicians should be better able to determine the various causes of recurrent miscarriage, evaluate the physiopathologic basis of some disorders, diagnose and treat women with recurrent miscarriages, and identify new trends in clinical research in this field.

Immunotherapy for recurrent miscarriage.

  • J. Scott
  • Medicine
    The Cochrane database of systematic reviews
  • 2000
Paternal cell immunization, third party donor leukocytes, trophoblast membranes, and IVIG provide no significant beneficial effect over placebo in preventing further miscarriages.

[Nutrition and miscarriages: a literature review].

Causes of fetal wastage.

  • J. Simpson
  • Medicine
    Clinical obstetrics and gynecology
  • 2007
Among nongenetic causes of first trimester fetal wastage, the best established are thyroid abnormities; antifetal antibodies; and the inherited and acquired thrombophilias, the latter are more established in the second trimester.

Antiphospohlipid syndrome in obstetrics.

Aspirin or anticoagulants for treating recurrent miscarriage in women without antiphospholipid syndrome.

There is a paucity in studies on the efficacy and safety of aspirin and heparin in women with a history of at least two miscarriages without apparent causes other than inherited thrombophilia, and the use of anticoagulants in this setting is not recommended.

Thyroid autoimmunity and miscarriage

It is of interest that women with high titers do not show a higher miscarriage rate when compared with women having low titers, although, there is no general agreement on this issue.

Natural killer cells and pregnancy outcomes in women with recurrent miscarriage and infertility: a systematic review.

The prognostic value of measuring pNK or uNK cell parameters remains uncertain and more studies are needed to confirm or refute the role of NK cell assessments as a predictive test for screening women who may benefit from immunotherapy.