Recurrent Pregnancy Loss

Question 1

How do you define recurrent pregnancy loss?

Answer 1

Recurrent pregnancy loss is 2 or more consecutive pregnancy loss less than 20 weeks gestation

Question 2

What is your differential diagnosis for the causes of recurrent pregnancy loss?

Answer 2

• Mullerian dysgenesis (bicornuate uterus/arcuate uterus/septated uterus)
• Parental balanced transfusion
• Diabetes
• Thyroid disease
• Aneuploidy
• Autoimmune disease
• Idiopathic

Question 3

What workup do you perform in patients with a history of recurrent pregnancy loss?

Answer 3

• TSH
• HbA1c
• Sonohysterogram/hysterosalpingogram
• APS antibody
• Thrombophilia if family history or personal history present
• Parental karyotype

Question 4

How do you counsel patients for future pregnancy outcomes if she has a history of recurrent pregnancy loss and no prior live births?

Answer 4

75% chance of live birth within 2 years if less than 30 years old
40% chance if 40 years old

Risk of SAB after 2 losses is 30%