Hello and welcome to the zero to finals podcast. My name is Tom and in this episode I'm going to be

talking to you about recurrent miscarriages. And you can find written notes on this topic at

zero to finals.com slash recurrent miscarriage or in the early pregnancy section of the zero to finals obstetrics and gynecology book.

So let's get straight into it.

Miscarriage is relatively common.

Recurrent miscarriage is classed as three or more consecutive miscarriages.

The risk of miscarriage increases with age, with the rate of miscarriage approximately

10% in women aged 20 to 30 years, 15% in women aged 30 to 35 years, 25% in women aged 35 to 40 years, and 50% in women aged 35 to 40 years and 50% in women aged 40 to 45 years.

Investigations are initiated after three or more first trimester miscarriages, or one or more second

trimester miscarriages.

Let's go through the causes.

The causes are idiopathic, particularly in older women, meaning no clear causes found.

Anti-phospholipid syndrome, which is a key one to remember.

Hereditary thrombophilias, uterine abnormalities, genetic factors in the

parents, for example, balanced translocations in the parental chromosomes, chronic histiocytic

intervillocytis, and other chronic conditions such as diabetes, untreated thyroid disease, and systemic

lupus erythematosis, or SLE. Let's talk in more detail about antifospholipid syndrome.

Antifospholipid syndrome is a disorder associated with antifospholipid antibodies, where the blood

becomes prone to clotting. The patient is in a hypercoagulable state, meaning prone to clotting.

The main associations are with thrombosis and complications in pregnancy, particularly recurrent miscarriage.

Antifospholipid syndrome can occur on its own or secondary to an autoimmune condition such as

systemic lupus erythematosis or SLE.

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