3 or more pregnancy losses

Aetiology

• Antiphospholipid syndrome
• Thrombophilia
• Balanced translocation (rare)
• Uterine abnormality - associated with late first trimester losses
• Independent risk factors - age and previous miscarriages

Management

• Use of LDA and daily fragmin injections after confirmation of viable IUP in evidence of APS
• Use of progesterone pessary in unexplained cases if age > 35 years and 2 or more losses