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Semin Reprod Med 2011; 29(6): 463-469
DOI: 10.1055/s-0031-1293200
© Thieme Medical Publishers

First Trimester Miscarriage Evaluation

Ruth B. Lathi1 , Florette K. Gray Hazard2 , Amy Heerema-McKenney2 , Joanne Taylor4 , Jane Tsung Chueh3
  • 1Department of Obstetrics and Gynecology, Recurrent Pregnancy Loss Program, Stanford University, Stanford, California
  • 2Department of Pathology, Stanford University, Stanford, California
  • 3Department of Obstetrics & Gynecology, Maternal & Fetal Medicine, Stanford University, Stanford, California
  • 4Department of Perinatal Genetic Counseling, Lucile Packard Children's Hospital at Stanford, Stanford, California
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Publication History

Publication Date:
08 December 2011 (online)

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ABSTRACT

Miscarriage is a relatively common occurrence for otherwise healthy women. Despite its frequency, evaluation for cause is rare. The most common cause of miscarriage is sporadic chromosome errors. Chromosomal analysis of the miscarriage offers an explanation in at least 50% of cases. Conventional cytogenetic evaluation can only be done on fresh tissue, so it is critical that the treating physician consider genetic testing at the time of the miscarriage. Ultrasound can estimate the gestational age at the time of miscarriage and identify major abnormalities in some embryos. A careful pathological examination can add to the evaluation by ruling out rare disorders with the highest recurrence risk. A multidisciplinary approach to miscarriage evaluation is essential to understanding the cause and risk of recurrence. A thorough evaluation of a miscarriage, in combination with emotional support, can often provide the necessary reassurance and confidence as the patient prepares for her next pregnancy.

KEYWORDS

Miscarriage - ultrasound - aneuploidy - pathology - pregnancy loss

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Ruth B. LathiM.D. 

Department of Obstetrics and Gynecology, Recurrent Pregnancy Loss Program, Stanford University

300 Pasteur Drive HH333, Stanford, CA 94305

Email: rlathi@stanford.edu