Recurrent miscarriage
Recurrent miscarriage is defined as the loss of three or more pregnancies. Maternal age and number of previous miscarriages are two independent risk factors for a further miscarriage. Advanced maternal age adversely affects ovarian function, giving rise to lower number of good quality oocytes, resulting in chromosomally abnormal conceptions that rarely develop further. All couples with a history of recurrent miscarriage should have peripheral blood karyotyping performed. In all couples with a history of recurrent miscarriage cytogenetic analysis of the products of conception should be performed if the next pregnancy fails. All women with recurrent miscarriage should have a pelvic ultrasound to assess uterine anatomy and morphology. In women with a history of recurrent miscarriage and anti phospholipid syndrome, future live birth rate is significantly improved when a combination therapy of aspirin plus heparin is prescribed.
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