The purpose of this study was to evaluate etiology and pregnancy outcome of
recurrent miscarriage women. The enrolled patients (280) were evaluated for
Triiodothyronine,
Thyroxine,
Thyroid stimulating hormone,
prolactin, chromosomal analysis, Haemoglobin A1C,
blood sugar, Magnetic resonance imaging, 3D-ultrasound, auto-
antibodies profile (
antiphospholipid antibodies,
anticardiolipin antibodies,
lupus anticoagulant,
antinuclear antibodies, anti-thyroid
antibodies and β2 glycoprotein1), torch profile (Toxoplasmo gondii,
rubella, cytomegalo virus and herpes simplex virus), blood
vitamin D3 levels, psychological factors, Body mass index and thrombotic factors (
protein S and C
deficiency, Prothrombin G20210A mutation, anti-
thrombin III,
Factor V Leiden and
Methylenetetrahydrofolate reductase mutation), uterosalpingography (hysteronsalpingography) and hysteroscopy. The therapeutic regimens either singly or combined were employed for the treatment of
recurrent miscarriage patients on the basis of etiology (single or multiple) and include
intravenous immunoglobulin,
low molecular weight heparin, low dose
aspirin,
levothyroxine,
progesterone,
folic acid, human chorionic gonadotrophin,
vitamin D3, psychotherapy, genetic counselling. However, patients with idiopathic
recurrent miscarriage were treated with
progesterone supplementation, anticoagulation and/or immune modulatory agents. The incidence of primary
recurrent miscarriage was highest and most of the women experienced
recurrent miscarriage during first trimester. Endocrinological disorders (39%) were found as the major pathological factor for
recurrent miscarriage. Other factors include uterine abnormalities (5.7%),
vitamin D3 deficiency (3.5%), psychological factors (3.2%)
infection (3.6%), autoimmune abnormalities (1.8%) and
protein S deficiency (1.8%). However, 40% cases were idiopathic. The overall live birth rate achieved after the management of
recurrent miscarriage patients was 75.7%. Enocrinopathy was the major cause of
recurrent miscarriage. The overall live birth rate achieved was 75.7% with highest pregnancy outcome in secondary
recurrent miscarriage patients after the management.