Spontaneous early pregnancy loss is a common problem, with approximately 15% of all clinically recognized pregnancies resulting in pregnancy failure. Early pregnancy loss, also referred to as miscarriage or spontaneous abortion, is defined as the loss of a clinical pregnancy before 20 completed weeks of gestational age. Recurrent pregnancy loss is defined as three consecutive spontaneous miscarriages.
Diagnostic evaluation should include maternal and paternal karyotypes, assessment of the uterine anatomy, and evaluation for thyroid dysfunction, Anti phospholipid syndrome, and selected thrombophilias. In some women, evaluation for insulin resistance, ovarian reserve, antithyroid antibodies, and prolactin disorders may be indicated.
Although the diagnosis of RPL can be quite devastating for the physician and patient, the overall prognosis is encouraging. even after 4 consecutive losses a patient has a greater than 60% to 65% chance of carrying her next pregnancy to term.