Elsevier

Fertility and Sterility

Volume 93, Issue 4, 1 March 2010, Pages 1234-1243
Fertility and Sterility

Recurrent pregnancy loss
Diagnostic factors identified in 1020 women with two versus three or more recurrent pregnancy losses

Presented at the 62d Annual Meeting of the American Society for Reproductive Medicine, which was held in New Orleans, Louisiana, on October 21–25, 2006.
https://doi.org/10.1016/j.fertnstert.2009.01.166Get rights and content
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Objective

To determine whether the frequency of abnormal results for evidence-based diagnostic tests differed among women with recurrent pregnancy loss (RPL) based on the number of prior losses (n = 2, 3, or ≥4) and to determine whether abnormal results for additional investigative diagnostic tests differed in prevalence among women with different numbers of pregnancy losses.

Design

Single-center, retrospective study.

Setting

Patients with RPL at a private practice.

Patient(s)

One thousand twenty women who had two or more consecutive spontaneous pregnancy losses with the same partner.

Intervention(s)

None.

Main Outcome Measure(s)

Frequencies of abnormal results for evidence-based diagnostic tests considered definite or probable causes of RPL (karyotyping for parental chromosomal abnormalities; pelvic sonohysterography, hysterosalpingogram, or hysteroscopy for uterine anomalies; immunological tests for lupus anticoagulant and anticardiolipin antibodies; thrombophilic tests for the factor V Leiden mutation; and blood tests for thyroid-stimulating hormone [TSH] and fasting blood glucose). We also measured the frequency of abnormal results for nine additional investigative tests in the same patients (antiphosphatidyl serine antibodies, microbial infection, midluteal P, PRL, functional protein C activity, functional protein S activity, antithrombin activity, fasting homocysteine and methylenetetrahydrofolate reductase polymorphisms, and factor II mutation).

Result(s)

The prevalence of abnormal results for evidence-based and investigative diagnostic tests did not differ among women with different numbers of pregnancy losses.

Conclusion(s)

Evaluation of all couples with two, three, or more consecutive miscarriages is recommended.

Key Words

Recurrent pregnancy loss
miscarriages
antiphospholipid antibodies
thrombophilias
evidence-based

Cited by (0)

C.R.J. has nothing to disclose. J.L.C. has nothing to disclose. W.H.K. has nothing to disclose.

Supported by a Creative Advance Planning Sabbatical Grant from the Andrew W. Mellon Foundation and by the Frank Ling Research Grant in Obstetrics and Gynecology from the University of Tennessee Health Science Center, Memphis, Tennessee.