Abstract
Evaluation of recurrent pregnancy loss (RPL) can proceed after two or more consecutive clinical pregnancy losses, but it requires a thorough evaluation of couples after three or more pregnancy losses. Evaluation includes a detailed history and examination considering the known causes of RPL. Investigations include assesment of endocrinological causes like thyroid, diabetes, assesment of thrombophilias, anatomical causes and genetic factors.
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Practice Committee of the American Society for Reproductive Medicine. Definitions of infertility and recurrent pregnancy loss. Fertil Steril. 2008;89:1603.
Regan L, Backos M, Rai R. The investigation and treatment of couples with recurrent first-trimester and second-trimester miscarriage. RCOG Green-top Guideline No. 17. April 2010. Accessed 1 April 2011.
Salat-Baroux J. Recurrent spontaneous abortions. Reprod Nutr Dev. 1988;28:1555–68.
Regan L, Braude PR, Trembath PL. Influence of past reproductive performance on risk of spontaneous abortion. BMJ. 1989;299:541–5.
Stirrat GM. Recurrent miscarriage. Lancet. 1990;336(8716):673–5. http://dx.doi.org/10.1016/0140-6736(90)92159-F.
Hanson U, Persson B, Thunell S. Relationship between haemoglobin A1C in early type 1 (insulin-dependent) diabetic pregnancy and the occurrence of spontaneous abortion and fetal malformation in Sweden. Diabetologia. 1990;33:100–4.
Abalovich M, Gutierrez S, Alcaraz G, Maccallini G, Garcia A, Levalle O. Overt and subclinical hypothyroidism complicating pregnancy. Thyroid. 2002;12:63–8.
Grimbizis GF, Camus M, Tarlatzis BC, Bontis JN, Devroey P. Clinical implications of uterine malformations and hysteroscopic treatment results. Hum Reprod Update. 2001;7:161–74.
Lockwood C, Wendel G, Committee on Practice Bulletins—Obstetrics. Practice bulletin no. 124: inherited thrombophilias in pregnancy. Obstet Gynecol. 2011;118:730–40.
de Braekeleer M, Dao TN. Cytogenetic studies in couples experiencing repeated pregnancy losses. Hum Reprod. 1990;5:519–28.
Stephenson MD, Awartani KA, Robinson WP. Cytogenetic analysis of miscarriages from couples with recurrent miscarriage: a case-control study. Hum Reprod. 2002;17:446–51.
Leitich H, Kiss H. Asymptomatic bacterial vaginosis and intermediate flora as risk factors for adverse pregnancy outcome. Best Pract Res Clin Obstet Gynaecol. 2007;21:375–90.
Ugwumadu A, Manyonda I, Reid F, Hay P. Effect of early oral clindamycin on late miscarriage and preterm delivery in asymptomatic women with abnormal vaginal flora and bacterial vaginosis: a randomised controlled trial. Lancet. 2003;361:983–8.
Stagnaro-Green A, Abalovich M, Alexander E, et al. Guidelines of the American Thyroid Association for the diagnosis and management of thyroid disease during pregnancy and postpartum. Thyroid. 2011;21(10):1081–125. http://dx.doi.org/10.1089%2Fthy.2011.0087.
Alexander EK. Thyroid autoantibodies and pregnancy risk. Nat Rev Endocrinol. 2011;7(9):501–2.
Rey E, Kahn SR, David M, Shrier I. Thrombophilic disorders and fetal loss: a meta-analysis. Lancet. 2003;361:901–8.
Out HJ, Kooijman CD, Bruinse HW, Derksen RH. Histopathological findings in placentae from patients with intra-uterine fetal death and anti-phospholipid antibodies. Eur J Obstet Gynecol Reprod Biol. 1991;41:179–86.
Homer HA, Li TC, Cooke ID. The septate uterus: a review of management and reproductive outcome. Fertil Steril. 2000;73(1):1–14.
Christiansen O, Nybo Andersen A, Bosch E, Daya S, Delves PJ, Thomas V. Evidence-based investigations and treatments of recurrent pregnancy loss. Fertil Steril. 2005;83(4):821–39.
The investigation and treatment of couples with recurrent first trimester and second trimester miscarriage. Greentop guideline no. 17, Aprill 2011.
Jauniaux E, Farquharson RG, Christiansen OB, Exalto N. Evidence based guidelines for the investigation and medical treatment of recurrent miscarriage. Hum Reprod. 2006;21:2216–22.
https://www.eshre.eu/Guidelines/Guidelines/Recurrent Pregnancy loss. Nov 2017.
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Wadhwa, L., Deepika (2018). Evidence-Based Clinical and Investigative Workup of RPL Couples. In: Mehta, S., Gupta, B. (eds) Recurrent Pregnancy Loss. Springer, Singapore. https://doi.org/10.1007/978-981-10-7338-0_14
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DOI: https://doi.org/10.1007/978-981-10-7338-0_14
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