Current management of recurrent pregnancy loss
Mark R Chester, Anushka Tirlapur, Kanna Jayaprakasan
Abstract
Key content Referral criteria to recurrent pregnancy loss (RPL) services vary, owing in part to a lack of consensus on the definition of RPL. Good quality evidence is limited, and controversies exist on recommendations for investigations and management of RPL. People with RPL will most likely achieve a live birth in their next pregnancy but should have an individualised approach that identifies and corrects any modifiable risk factors and offers appropriate psychological support. Learning objectives To look at the variations in definition and aetiology of RPL and use current evidence available for recommendations towards investigations and management of RPL. To be familiar with evidence‐based guidelines published by the Royal College of Obstetricians and Gynaecologists, the American Society for Reproductive Medicine and the European Society of Human Reproduction, as well as recently published data, which will help to improve clinical outcome utilising the interventions with proven efficacy. Ethical issues Differences in referral criteria and the controversies around RPL mean there can be considerable variation in how these patients are managed between services. The lack of good quality evidence can result in patients opting for management strategies with unproven efficacy.