An Update on Recurrent Early Pregnancy Loss: Causes, Controversies and Cure

Abstract

Recurrent Pregnancy Loss (RPL) is an important reproductive issue, affecting 1-5% of couples. It is characterised by repeated miscarriage, impairing the ability to have a live birth. The proven causes are diverse, such as cytogenetic abnormality, uterine anomalies, antiphospholipid antibody, metabolic and endocrine abnormalities, and about 50% cases of RPL remain still unexplained. To facilitate the diagnosis, different screening tests have been recommended, such as antiphospholipid antibody tests, thyroid stimulating hormone, glucose tolerance test, chromosomal assessment, ultrasound testing etc. RPL is associated with psychological trauma and financial burden. An evidence-based treatment is available for the majority of causes and it is seen that most of the women eventually become pregnant with an appropriate treatment plan, regardless of the cause. It has also been shown that patients presenting no abnormality on various tests may achieve a good rate of live births without special treatment. This study also includes certain controversial aetiologies and unconventional tests. This review touches on the management of various abnormalities in brief. Recurrent pregnancy loss has a significant negative life impact due to its repetitive nature; however, emotional care along with appropriate management improves chances of future pregnancy.

Keywords

• antiphospholipid antibodies
• cytogenetic abnormalities
• immunology
• recurrent miscarriage
• uterine anomalies