Human Reproduction, Vol 12, 387-389, Copyright © 1997 by Oxford University Press
K Clifford, R Rai and L Regan
The future pregnancy outcome of 201 consecutive women, median age 34 years
(range 22-43), with a history of unexplained recurrent first trimester
miscarriage (median 3; range 3-13), was studied. All women and their
partners had normal peripheral blood karyotypes; none had antiphospholipid
antibodies and none hypersecreted luteinizing hormone (LH). No
pharmacological treatment was prescribed and early pregnancy supportive
care was encouraged. Women aged < or = 30 years had a subsequent
miscarriage rate of 25% (14/57) which rose to 52% (13/25) in women aged
> or = 40 years (P = 0.02). After three consecutive miscarriages, the
risk of miscarriage of the next pregnancy was 29% (34/119) but increased to
53% (9/17) after six or more previous losses (P = 0.04). A past history of
a livebirth did not influence the outcome of the next pregnancy. Supportive
care in early pregnancy conferred a significant beneficial effect on
pregnancy outcome. Of 160 women who attended the early pregnancy clinic, 42
(26%) miscarried in the next pregnancy compared with 21 out of 41 (51%) who
did not attend the clinic (P = 0.002). After thorough investigation, women
with unexplained recurrent first trimester miscarriage have an excellent
pregnancy outcome without pharmacological intervention if offered
supportive care alone in the setting of a dedicated miscarriage clinic.
ARTICLES
Future pregnancy outcome in unexplained recurrent first trimester miscarriage
Department of Obstetrics and Gynaecology, Imperial College School of Medicine at St. Mary's, London, UK.
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