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Chapter-04 Recurrent Pregnancy Loss

BOOK TITLE: An Introduction to Genetics and Fetal Medicine

Author
1. Dada Rima
2. Agarwal Neerja
ISBN
9788184489606
DOI
10.5005/jp/books/11186_4
Edition
2/e
Publishing Year
2010
Pages
10
Author Affiliations
2. All India Institute of Medical Sciences, New Delhi, India
Chapter keywords

Abstract

Recurrent Miscarriage is referred to as three or more consecutive pregnancy losses before 20-22 weeks of gestation and may affect as many as 1-3% of childbearing women. Inherited Pregnancy Loss Working Group defines recurrent miscarriage as three or more clinically recognized consecutive or non-consecutive pregnancy losses occurring prior to fetal viability (< 24 weeks). Based on the health provider’s professional judgment, evaluation of couples with two miscarriages may be initiated when deemed necessary especially when taking into account the woman’s age and length of time that the couple spent trying to have a successful pregnancy. It is not unusual for perfectly healthy couples to experience three consecutive spontaneous pregnancy losses, each for a different reason and it has been seen that more than half of recurrent abortions are due to non-recurrent causes. It is a very frustrating condition for both the couple and the clinician, because it is rare to find a clear-cut reason for the repeated failure to sustain a pregnancy and, as a consequence, the prospect of a satisfactory treatment. Sperm factors like oxidative stress (OS) and DNA damage are important factors which can lead to RSA. Test for OS and DNA damage analysis must be included in diagnostic workup of couples experiencing RSA as these tests have better diagnostic and prognostic capabilities. Thus sperm are not mere vectors of paternal DNA but their function extends clearly beyond fertilization and plays a dynamic role in embryonic/fetal viability/health of conceptus.

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