Anatomic Factors in Recurrent Pregnancy Loss

Anne S. Devi Wold, MD; Norma Pham, MD; Aydin Arici, MD

Disclosures

Semin Reprod Med. 2006;24(1):25-32. 

In This Article

Summary

Anatomic uterine defects are present in 15% of women evaluated for RPL. The septate uterus is the most common congenital uterine anomaly. It is associated with the highest incidence of reproductive failure such as RPL and preterm delivery (PTD). Pregnancy outcome is improved significantly after hysteroscopic metroplasty. Severe uterine synechiae, leiomyomas, and uterine abnormalities associated with DES exposure are also associated with RPL. Women exposed to DES should be observed closely for ectopic pregnancy, spontaneous abortion, and PTD. The use of prophylactic cerclage in women exposed to DES may be beneficial, although a consensus is lacking. An accurate diagnosis of the uterine defect is essential for successful treatment and improved outcome in women with RPL.

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