Recurrent pregnancy loss: Summary and clinical recommendations

Recurrent pregnancy loss (RPL) is traditionally defined as three or more co nsecutive pregnancy losses before 20 weeks of gestation. This problem occur s in approximately 1% of all couples and is a frustrating problem for both the patient and physician. This article provides an overview of the problem , including causes, treatments, and recommendations. Among the numerous pro posed causes of RPL, only parental karyotype abnormalities, antiphospholipi d syndrome, uterine malformations, and cervical incompetence are universall y accepted. There are numerous treatments for RPL, but only the efficacy of heparin and low-dose aspirin in women with antiphospholipid syndrome has b een established with properly controlled trials. Even after undertaking a c omplete evaluation, the cause of RPL remains uncertain in over 50% of cases . These patients should understand that subsequent pregnancies have up to a 70% chance of success without treatment.