The World Health Organization (WHO) defines miscarriage as the loss of a fetus or embryo weighing less than half a kilogram before three weeks gestation. Classically, although the cut-off point was established at three or more miscarriages, there is no consensus, since most authors consider that with two miscarriages it is possible to speak of repeat miscarriage and a study of the couple should be initiated. The possibility of a new miscarriage after two or three losses is similar and may already indicate an underlying problem.
What is the basis for the change in criteria to determine whether or not it is a repeat miscarriage?
- The most important predictor of miscarriage in a pregnancy is the existence of one or more previous miscarriages.
- Waiting to start the analysis until the third miscarriage does not increase the chances of finding a cause.
What are the causes of repeat miscarriage?
- Chromosomal, antiphospholipid syndrome (APS).
- Uterine factors, some inherited thrombophilias.
- Endocrine, infectious, other autoimmune, seminal factor.
- Under investigation: alloimmune, endometrial, psychological, environmental.
Repeat miscarriages are a challenge for reproductive specialists, since only hematological or autoimmune diseases are treatable.
Can repeat miscarriages be prevented?
One way to try to prevent is not to postpone childbearing, since the percentage of miscarriages increases proportionally with age.