A longitudinal study of pregnancy outcome following idiopathic recurrent miscarriage

Recurrent miscarriage is a difficult clinical problem occurring in similar to 1-2% of fertile women. Following investigation, most cases fail to revea l an identifiable cause and are therefore classified as idiopathic, The aim of this study was to identify important gestational milestones for pregnan cy success prediction in women following idiopathic recurrent miscarriage. A total of 325 consecutive patients with idiopathic recurrent miscarriage w as involved in a prospective longitudinal observational study. Patients wer e identified from a miscarriage database of 716 patients. Preconceptual pre sentation and investigation excluded patients from the study sample with kn own associations of recurrent pregnancy loss, such as antiphospholipid synd rome, oligomenorrhoea, mid-trimester loss and other rare causes, e.g. abnor mal parental karyotype. Following early presentation in a subsequent pregna ncy, all patients followed a standard clinic protocol including fetal viabi lity ultrasonography on a fortnightly basis throughout the first trimester, Kaplan-Meier curves were constructed for pregnancy outcome. Out of 325 idi opathic cases, 70% (n = 226) conceived, with a 75% success rate. Of 55 misc arriages, longitudinal assessment showed that six losses occurred following detection of fetal cardiac activity (3%). Data from this large study group have enabled accurate prediction of future pregnancy success and have esta blished important gestational milestones for women,vith idiopathic recurren t miscarriage.