An evidence-based approach to recurrent pregnancy loss

South African Journal of Obstetrics and Gynaecology

Elzaan C van Niekerk¹  Theunis Frans Kruger¹  Igno Siebert¹ 

[1] Reproductive Biology Unit, Department of Obstetrics and Gynaecology, Faculty of Medicine and Health Sciences, Stellenbosch University, Parow, Cape Town, South Africa

关键词: Recurrent pregnancy loss;    Recurrent miscarriage;    Investigations;   

DOI  :  

学科分类：农业科学（综合）

来源: South African Medical Association

【 摘 要 】

Recurrent pregnancy loss (RPL) can be defined as more than two to three consecutive miscarriages before 24 weeks’ gestation. A literature review was done to provide an evidence-based approach to RPL, identifying the risk factors and causes and also looking at the various special investigations that form part of the work-up and trying to assess which have been proven to be effective or of negative impact, and which of the management options lead to a better outcome. We concluded that the following special investigations should be part of the work-up for all patients with RPL: ( i ) genetic counselling and karyotyping of the abortus; ( ii ) anticardiolipin antibodies and lupus anticoagulant testing must be done on two occasions, 6 - 8 weeks apart; ( iii ) all patients qualify for a pelvic ultrasound scan and hysteroscopy; ( iv ) syphilis testing must be done routinely; and ( v ) testing of thyroid function and glucose monitoring/glycosylated haemoglobin (HbA1c) measurement must be done in all patients with a history of thyroid disease or diabetes mellitus, or clinical manifestations thereof. In approximately 50% of couples the cause of RPL remains unexplained, even after evaluation.

【 授权许可】

Unknown