Recurrent Miscarriage
Recurrent miscarriage is the loss of two or more consecutive first trimester miscarriages. These include pregnancies confirmed by pregnancy test or ultrasound, as well as molar pregnancies (a particular type of pregnancy loss caused by over-development of the placenta).
Approximately 1 to 3 in every 100 women will experience recurrent miscarriage. If you have experienced two or more miscarriages there may be an underlying cause for this, therefore, tests are usually offered at this stage. The majority of women have completely normal test results.
In many cases (about half), no specific cause or risk factors are found. However, certain factors may increase the risk, such as:
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Increasing age
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Previous miscarriages
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Alcohol and caffeine consumption
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Body mass index (BMI)
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Underlying medical conditions
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Anatomical anomalies (where the shape of the womb is different)
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Genetics
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Male factors (e.g. sperm health).
Additional information is linked below.
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NWIHP/RCPI Plain Language Summary: ‘Recurrent Miscarriage’
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NWIHP/RCPI Guideline: ‘Recurrent Miscarriage’
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RCOG Patient Information Leaflet: ‘Recurrent Miscarriage’
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RCOG Green-Top Guideline: ‘The Investigations and Treatment of Couples with Recurrent First Trimester Miscarriage and Second Trimester Miscarriage’
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ESHRE guidelines: 'Recurrent Pregnancy Loss'
If you have experienced three or more consecutive miscarriages you may be referred to a dedicated Pregnancy Loss Clinic in CUMH. The clinic is run by medical and midwifery staff who are committed to supporting you through this time. This can include investigations such as blood tests, pelvic ultrasounds, etc. These are talked about more in the section below.
Pregnancy Loss Clinic at CUMH
A referral to the Pregnancy Loss Clinic at CUMH can be arranged by your GP or via the hospital. The aim of the clinic is to investigate the medical causes of recurrent pregnancy loss and to provide information and support to parents.
Referral is made on the basis of:
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Three consecutive first trimester pregnancy losses (recurrent miscarriage)
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Two consecutive first trimester pregnancy losses with no living children
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Any mid trimester (more than 14 weeks gestation) pregnancy loss
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Any second or third trimester pregnancy loss
This clinic is run by consultants and specialist midwives and is held on Ward 2 South at CUMH (first room on left after you enter double-doors to 2South, with teardrop sign on door).
At the clinic, a medical history is taken and the nature of your pregnancy loss is explored. A number of investigations, such as blood tests, may be suggested.
Plans for further pregnancy are discussed with follow up visits and referrals to other services sometimes required. However if the relevant test were performed by your GP, the EPAU/Aislinn Suite or 4 South ward prior to your clinic visit, your results and implications for a future pregnancy will be discussed.
Other investigations
The blood tests performed at the Pregnancy Loss Clinic are as follows
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Thyroid Function Tests
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HbA1c
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Antibody screen
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Thrombophilia screen
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Parental chromosome analysis (only after 3 consecutive miscarriages)
As mentioned above, these bloods may be performed by your GP before attending the Pregnancy Loss Clinic. Here you can find a link to this list of blood tests.
Following your visit to the Pregnancy Loss Clinic other tests may be recommended depending on your history. Such tests may include an ultrasound scan, which may be done to assess any abnormalities in the womb. A hysterosalpingogram, saline installation solography, an MRI scan or even a hysteroscopy can also be used to investigate womb or fallopian tube abnormalities.
More information can be found by downloading the documents below
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Miscarriage Association Leaflet: ‘Investigation Following Recurrent Miscarriage’
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Miscarriage Association Leaflet: ‘Pregnancy Loss and Infertility’
Some internet sources may suggest performing other tests following a miscarriage. However there is no scientific evidence that these tests have any relevance in the investigation of pregnancy loss. Such tests are not provided in our service.