Recurrent miscarriage

Question 1

Initial Ix of RMC

Scenario 1 - 32yo, 4th miscarriage, at 12/40, most recent been PPROM post cerclage (comm station)

Scenario 2 - 38yo, referred after 3 consecutive MC (Ix & Mx station)

Scenario 3 - 36yo, G3P0, 9/40 scan shows blight ovum - comm station er: likely outcome then possible Ix

Scenario 4 - 31yo, G3P0, hx of RMC & PI - never investigated

Answer 1

• 50% no cause found
• 70% livebirth rate w no rx
• TFT/thyroid autoabs/aPLs
• +/- prolactin +/- HbA1c
• Karyotype of POC vs parents
• Thrombotic (FVL/PT/ATIII/Prot S & C)
• Pelvic USS
• refer to RMC service
• MDI +/- genetics +/- RSU
• await ix to treat cause

+/- PI ix
+/- precon bloods
+/- precon advice