Recurrent Pregnancy Loss

Question 1

Criteria

Answer 1

3+ consecutive SABs in a year

Question 2

How are pts. screened?

Answer 2

Karyotype of both parents
Karyotype from POC from each of the SABs (if possible)

Examine maternal anatomy with Hysterosalpingogram (HSG) then Hysteroscopic/Laparoscopic exploration if HSG abnormal.

Screen for hypothyroidism, DM, Antiphospholipid Ab, Hypercoagulability, SLE, Factor V Leiden, Lupus anticoagulant, Russell Viper Venom, Antithrombin III, Protein C and S

Level of serum Progesterone in the luteal phase of the menstrual cycle

Cultures of cervix, vagina, endometrium

Question 3

Tx

Answer 3

IVF using donor sperm or ova
Cerclage if incompetent cervix
Progesterone if luteal phase defect
Low dose ASA for APA syndrome