Management of unexplained recurrent miscarriage

A significant number of couples investigated for recurrent miscarriage will have no cause identified to account for their pregnancy losses. While this is a frustrating situation for both patient and clinician, the prospective live-birth rate of women who are aPL negative is good [32]. The main determinants of future pregnancy outcome are the maternal age and the number of previous miscarriages she has had (Figs 13.4 and 13.5). A woman less than 38 years of age who has had less than five consecutive first trimester miscarriages and who is aPL negative has a 65% chance of her next pregnancy being successful with supportive care alone. While the scientific basis for the benefit of supportive care in early pregnancy remains to be elucidated, it is possible that elevated stress hormones (e.g. cathecholamines and cortisol) may be able to reduce fetal vascularization and oxygen supply and thereby induce miscarriage.

Pregnancy Nutrition

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