Recurrent pregnancy loss: summary and clinical recommendations

Area of Science:

• Reproductive Medicine
• Genetics
• Immunology

Background:

• Recurrent pregnancy loss (RPL) affects approximately 1% of couples, defined as three or more consecutive pregnancy losses before 20 weeks.
• It presents a significant challenge for patients and healthcare providers, necessitating a comprehensive understanding of its causes and management.

Purpose of the Study:

• To provide an overview of recurrent pregnancy loss (RPL).
• To discuss the established causes, available treatments, and evidence-based recommendations for managing RPL.
• To inform patients about the prognosis of future pregnancies.

Main Methods:

• Review of existing literature on recurrent pregnancy loss (RPL).
• Identification of universally accepted causes of RPL.
• Evaluation of the efficacy of various treatments for RPL based on controlled trials.

Main Results:

• Universally accepted causes of RPL include parental karyotype abnormalities, antiphospholipid syndrome, uterine malformations, and cervical incompetence.
• The efficacy of heparin and low-dose aspirin is established only for women with antiphospholipid syndrome.
• In over 50% of evaluated cases, the etiology of RPL remains undetermined.

Conclusions:

• Despite diagnostic challenges, RPL patients have a favorable prognosis for future pregnancies, with up to a 70% success rate even without specific interventions.
• Further research is needed to elucidate the causes and optimize treatments for RPL.
• Patient education regarding the high success rate of subsequent pregnancies is crucial.