Recurrent Pregnancy Loss in a Tertiary Care Center: A Retrospective Analysis

Lopamudra Pradhan, Lakshmidevi Muralidhar, Shreedhar Venkatesh, Madhva Prasad

Abstract

Background: Recurrent pregnancy loss (RPL)—a spontaneous loss of 3 pregnancies successively before 20 weeks of gestation—is a complex problem in women of reproductive age. Researchers are continuously studying various factors responsible for this condition.

Aims: To evaluate various etiologic factors causing RPL and to describe the types of uterine anomalies associated with RPL

Materials and Methods: This retrospective one-year observational study was conducted at Vydehi Institute of Medical Sciences and Research Centre (Bengaluru, Karnataka, India). The medical records and history of 43 women were reviewed, and various etiologic factors that contributed to RPL were noted. Demographic factors (ie, age and lifestyle habits), obstetric history (ie, gestational age at pregnancy loss), investigation reports (ie, endocrine, autoimmune, ultrasound, MRI, and hysterosalpingography findings), and surgical findings (ie, laparoscopy, hysteroscopy, or open procedure) were noted. The causes of the RPL were also noted.

Results: A total of 43 patients (mean age, 29.79 y) were studied. A majority of the pregnancy losses (41.8%) were observed in the first trimester, and 81% of the study population had a primary RPL. Uterine anomalies (34%), endocrine causes (30%), and autoimmune (21%) conditions were the most common causes of RPL.

Conclusion: RPL continues to be a challenge to obstetricians, mainly because of endocrine and anatomical causes, hypothyroidism, and septate uterus.