Recurrent pregnancy loss

Definition

• Three or more consecutive loses at less than 20 weeks gestation
• Primary (worse prognosis) or secondary (better prognosis)

Etiology

• Genetic/chromosomal
  • Trisomies
  • Turner syndrome
  • Translocations
• Uterine abnormalities
  • Septate uterus (90%)
  • Bicornate uterus
  • Didelphic uterus
  • Asherman syndrome
  • T-shaped uterus (DES exposure)
• Autoimmune
  • Anti-phospholipid antibody syndrome
  • Autoimmune thyroid disorder
• Hormonal
  • Literal phase defect
  • ?Hypothyroidism
  • ?Diabetes
• Thrombophlebitis
  • Factor V Leiden
• Infection

Risk factors

• Maternal age

Management

• If negative workup, progesterone may be helpful