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Predicting recurring miscarriage: what is important?

Predicting recurring miscarriage: what is important?

Obstetrics and Gynecology 82(1): 132-138

Objective: To audit the Miscarriage Clinic in Liverpool and to categorize women into those at low and high risk of a subsequent pregnancy loss. Methods: Over 4 years (1989-1992), 203 consecutive couples attended the Miscarriage Clinic in Liverpool. A data base was designed and a mathematical model formulated that described the data base. Results: A successful pregnancy outcome was most likely in the presence of the following features: menstrual regularity, fewer than four previous miscarriages, maternal age of less than 30 years, absence of antiphospholipid antibodies, and a previous live birth. Oligomenorrhea was a considerably more significant feature than any other in predicting a subsequent miscarriage. These high-risk oligomenorrheic women were found to have low luteal phase estradiol levels, but normal luteal phase progesterone profiles and normal LH profiles throughout the menstrual cycle. Conclusions: Women suffering from recurring miscarriage can be placed into differing risk categories. Women with a good prognosis require counseling alone. Women at high risk of a subsequent miscarriage had oligomenorrhea and an isolated deficiency of estradiol in the luteal phase of the menstrual cycle.

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Accession: 009227144

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PMID: 8515913

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