Recurrent Pregnancy Loss


           Recurrent miscarriage or fetal loss (RFL) syndrome is characterized by repeated spontaneous abortion. There are many syndromes associated with RFL, including anatomic anomalies, endocrine/hormonal abnormalities, genetic/chromosomal abnormalities, and blood coagulation protein/platelet defects. The exact prevalence of each of these conditions in inducing RFL remains unclear. However, if the clinician is astute and vigorously evaluates the patient with RFL, the causative defects may be diagnosed and treated, often making normal-term pregnancy possible.

Chromosomal abnormalities generally produces some phenotypic effect, most often congenital anomalies and mental retardation with numerous structural anomalies. These can be diagnosed by karyotype analysis of virtually any tissue type.

The family history may provide a clue to the presence of a familial chromosome rearrangement. A history of any congenital anomaly, mental retardation, infertility, spontaneous abortion, or perinatal death is significant because each is characteristic of chromosomal anomaly.

Coagulation defects ie hemorrhagic disorders comes about due to interference with adequate fibrin formation, thereby disrupting implantation of the fertilized ovum into the uterine lining. The thrombotic hemostasis defects associated with recurrent fetal loss include lupus anticoagulants and anticardiolipin antibodies.

Cervical Incompetence : Painless cervical dilatation during the second trimester, followed by bulging or rupture of the membranes and delivery of an immature fetus, typically suggests cervical incompetence.

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