Is recurrent miscarriage a useful clinical concept? 2014

Willem Vlaanderen
Malden, the Netherlands.

Many treatments have been used to increase the chances of an ongoing pregnancy after recurrent miscarriage (RM). Yet no clear evidence for an effective intervention has been found. Therefore, the clinical concept RM should be reconsidered. Both the statistical and clinical bases for RM are poor. If the individual risk is taken into account, then simple calculations explain the observed frequency of RM. Most miscarriages, either sporadic or recurrent, are abnormal in construction or development. Although some risk factors for miscarriage have been identified, such as age and number of previous miscarriages, the importance of other factors remains uncertain. RM has a favorable prognosis: the cumulative live birth rate is usually over 90% after two or three more attempts. So maternal systemic pathology does not seem to play a major role in the cause of RM. Little benefit can be expected from any intervention aimed at increasing the chance of a live birth. RM does not appear to be a real pathological entity that requires a special explanation. Moral support should replace medical interventions in most cases.

UI MeSH Term Description Entries
D011247 Pregnancy The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH. Gestation,Pregnancies
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000026 Abortion, Habitual Three or more consecutive spontaneous abortions. Abortion, Recurrent,Miscarriage, Recurrent,Recurrent Early Pregnancy Loss,Habitual Abortion,Habitual Abortions,Recurrent Abortion,Recurrent Abortions,Recurrent Miscarriage,Recurrent Miscarriages
D000367 Age Factors Age as a constituent element or influence contributing to the production of a result. It may be applicable to the cause or the effect of a circumstance. It is used with human or animal concepts but should be differentiated from AGING, a physiological process, and TIME FACTORS which refers only to the passage of time. Age Reporting,Age Factor,Factor, Age,Factors, Age
D012307 Risk Factors An aspect of personal behavior or lifestyle, environmental exposure, inborn or inherited characteristic, which, based on epidemiological evidence, is known to be associated with a health-related condition considered important to prevent. Health Correlates,Risk Factor Scores,Risk Scores,Social Risk Factors,Population at Risk,Populations at Risk,Correlates, Health,Factor, Risk,Factor, Social Risk,Factors, Social Risk,Risk Factor,Risk Factor Score,Risk Factor, Social,Risk Factors, Social,Risk Score,Score, Risk,Score, Risk Factor,Social Risk Factor

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