Recurrent Spontaneous Abortions- An Update on Diagnosis and Management

Recurrent spontaneous abortions (RSA), defined as three or more consecutive miscarriages, affect 1 % of couples trying to conceive. Risk of abortion is 15 % in every pregnancy, increasing with the number of previous miscarriages. While 50 70 % of sporadic abortions are attributed to chromosomal defects, mostly trisomies, in RSA there are different underlying disorders of uterine, genetic, infectious, endocrine, immune or thrombophilic etiology, but about 25 40 % are of still unknown etiology. While specific therapy for uterine, infectious, and endocrine disorders may be applied, treatment options for some immunologic and thrombophilic disturbances are still under examination. Careful counseling must be offered to patients with RSA of unknown etiology, as not all treatment options widely offered are based on sufficient evidence yet.