A review of reproductive outcomes of women with two consecutive miscarriages and no living child

Abstract

The definition of recurrent miscarriage ranges from two miscarriages according to the American Society for Reproductive Medicine and the European Society of Human Reproduction and Embryology, to three consecutive pregnancy losses as defined by the Royal College of Obstetricians and Gynaecologists. Recent guidelines emphasise the need for further research on the effect of various recurrent miscarriage definitions on diagnosis, treatment and prognosis. Our study examines the management and pregnancy outcomes of nulliparous women attending Cork University Maternity Hospital’s Pregnancy Loss Clinic, between 2009 and 2014, with their second consecutive first-trimester miscarriage. Information was sourced from the Pregnancy Loss Clinic’s database, hospital patient management and laboratory systems, and clinical letters. 294 women were identified. A subsequent pregnancy was conceived by 82.3% (242/294) of women, with 72.7% (176/242) achieving a live birth. In conclusion, supportive care and selective medical management in dedicated pregnancy loss and early pregnancy clinics achieve excellent reproductive outcomes.