A clinical approach to recurrent pregnancy loss

A diagnosis of recurrent pregnancy loss can be considered after the loss of two or more pregnancies before 24 weeks' gestation. In most couples no pathological cause is identified. The outcome can be improved for women with recurrent pregnancy loss and antiphospholipid syndrome with treatment with aspirin and/or heparin. Couples with unexplained recurrent pregnancy loss have an excellent prognosis with supportive care alone and to date no pharmacological intervention has been proven to be beneficial. This review describes the causes of recurrent pregnancy loss, the clinical work-up and an evidence-based approach to management.