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Recurrent miscarriage and thrombophilia: an update

McNamee, Kelly; Dawood, Feroza; Farquharson, Roy

Current Opinion in Obstetrics and Gynecology: August 2012 - Volume 24 - Issue 4 - p 229–234
doi: 10.1097/GCO.0b013e32835585dc
REPRODUCTIVE ENDOCRINOLOGY: Edited by David L. Olive
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Purpose of review Acquired and inherited thrombophilia is an important research avenue in the recurrent miscarriage field. The optimum treatment for patients with recurrent miscarriage and a confirmed thrombophilia remains a contentious issue. We aim to appraise and explore the latest research in the field of thrombophilia and recurrent miscarriage in this review.

Recent findings Antiphospholipid syndrome (APS) is the only proven thrombophilia that is associated with adverse pregnancy outcomes. Research involving inherited thrombophilia and recurrent miscarriage is limited to small observational studies with small and heterogeneous populations. Aspirin and heparin therapy are frequently prescribed for APS, yet there is no robust evidence for the most efficacious regime. The combination of inherited hypercoagulability and environmental factors in association with recurrent miscarriage has recently been explored as an aid to identify high-risk individuals.

Summary The cause of recurrent miscarriage is multifactorial and appropriate treatment continues to be a challenge. Laboratory tests need to be standardized and well designed multicentre research trials are essential to expand on the current knowledge base with the aim to produce strong evidence-based medicine.

Liverpool Women's NHS Foundation Trust, Liverpool, UK

Correspondence to Kelly McNamee, Liverpool Women's NHS Foundation Trust, Crown Street, Liverpool L8 7SS, UK. Tel: +44 151 708 9988; e-mail: kellymcnamee@doctors.org.uk

© 2012 Lippincott Williams & Wilkins, Inc.