review · Journal of Clinical Medicine
Recurrent pregnancy loss lacks a universally accepted clinical definition, with variations regarding the required number of spontaneous abortions, pregnancy types, and gestational age. These inconsistencies make estimating the true incidence difficult, though reported rates range between one and five percent. The condition is polyetiological and multifactorial, involving both modifiable and non-modifiable factors, yet up to seventy-five percent of cases remain unexplained even after thorough evaluation. Current diagnostic and management approaches depend largely on the specific risk factors identified by healthcare professionals for individual patients. Underestimating the broader health and social consequences compromises women's reproductive health and psychological well-being. Continued investigation into risk factors, particularly for unexplained cases, is required alongside updates to existing international guidelines to support clinical practice.
Recurrent pregnancy loss affects up to five percent of pregnancies, yet three out of four cases remain unexplained. Inconsistent medical definitions and guidelines complicate clinical care, which can negatively affect women's reproductive health and mental well-being. Clarifying causes and updating international clinical standards is necessary to ensure affected couples receive consistent, evidence-based care and proper psychological support.
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Recurrent pregnancy loss is a complex health challenge with no universally accepted definition. Inconsistency in definitions involves not only the number of spontaneous abortions (two or three) that are accepted for recurrent pregnancy loss but the types of pregnancy and gestational age at miscarriage. Due to the heterogeneity of definitions and criteria applied by international guidelines for recurrent pregnancy loss, the true incidence of recurrent miscarriage, which is reported to range from 1% to 5%, is difficult to estimate. Moreover, the exact etiology of recurrent pregnancy loss remains questionable; thus, it is considered a polyetiological and multifactorial condition with many modifiable and non-modifiable factors involved. Even after thoroughly evaluating recurrent pregnancy loss etiology and risk factors, up to 75% of cases remain unexplained. This review aimed to summarize and critically analyze accumulated knowledge on the etiology, risk factors, relevant diagnostic options, and management approach to recurrent pregnancy loss. The relevance of various factors and their proposed roles in recurrent pregnancy loss pathogenesis remains a matter of discussion. The diagnostic approach and the management largely depend on the etiology and risk factors taken into consideration by a healthcare professional as a cause of recurrent miscarriage for a particular woman or couple. Underestimation of social and health consequences of recurrent pregnancy loss leads to compromised reproductive health and psychological well-being of women after miscarriage. Studies on etiology and risk factors for recurrent pregnancy loss, especially idiopathic, should be continued. The existing international guidelines require updates to assist clinical practice.
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DOI: 10.3390/jcm12124074
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