[Recurrent spontaneous miscarriage]

Spontaneous recurrent miscarriages still represent a poorly defined entity. It is commonly accepted that they include early (1st trimester) spontaneous abortion thus excluding those related to well documented chromosomal, anatomical, hormonal or autoimmune causes such as SLE or anticardiolipin syndrome. There is also a general consensus based upon historical series to require at least three consecutive miscarriages. In a series of 58 consecutive couples with recurrent miscarriages studied at the clinics of immunology of pregnancy, a careful investigation could demonstrate the high incidence of anatomical abnormalities detected by hysterosalpingography and consisting mostly of uterus bicornis or uterus septus. This finding emphasises the importance of this examination. Some of these cases required surgical or endoscopic therapy. Only one patient displayed chromosome abnormalities excluding her from the definition of spontaneous recurrent miscarriage. The other patients were treated either with paternal leucocytes or gammaglobulins.